Which intervention is most important for the practical nurse (PN) to implement for a client who is receiving total parenteral nutrition (TPN)?
A.
Collect fingerstick glucose levels
B.
Implement bleeding precautions.
C.
Obtain daily weights
D.
Check urine for albumin
The correct answer and Explanation is :
The most important intervention for a practical nurse (PN) to implement for a client receiving total parenteral nutrition (TPN) is:
A. Collect fingerstick glucose levels
Explanation:
Total Parenteral Nutrition (TPN) is a method of delivering nutrients directly into the bloodstream, bypassing the digestive system. This approach is often used for patients who cannot eat or absorb nutrients through their gastrointestinal tract. While TPN provides essential nutrients, it also carries specific risks and requires diligent monitoring to prevent complications.
Monitoring Blood Glucose Levels:
- Risk of Hyperglycemia: One of the primary concerns with TPN is the risk of hyperglycemia (high blood glucose levels). TPN solutions typically contain a high concentration of glucose to meet the caloric needs of the patient. The body’s ability to manage this glucose load can be compromised, especially in patients with diabetes or those whose glucose metabolism is impaired. Regular monitoring of blood glucose levels is essential to detect and manage hyperglycemia promptly, which can help prevent serious complications such as diabetic ketoacidosis or hyperosmolar hyperglycemic state.
- Adjustment of TPN Components: Regular glucose monitoring allows for the adjustment of TPN composition. If blood glucose levels become elevated, adjustments can be made to the glucose concentration in the TPN solution, or insulin can be administered as needed to help maintain blood glucose within a normal range.
- Early Detection of Metabolic Imbalances: Monitoring glucose levels also aids in the early detection of metabolic imbalances, which can be indicative of other complications related to TPN, such as liver dysfunction or infection.
Other Interventions:
- B. Implement Bleeding Precautions: While bleeding precautions are important, they are not specific to the administration of TPN. They would be more relevant if the patient had bleeding disorders or was on anticoagulants.
- C. Obtain Daily Weights: Daily weights are important for monitoring fluid balance and nutritional status but do not directly address the immediate risks associated with TPN.
- D. Check Urine for Albumin: Checking urine for albumin can be relevant for assessing kidney function and protein status but is not as critical as monitoring blood glucose levels for patients on TPN.
In summary, regular monitoring of blood glucose levels is crucial for managing the metabolic effects of TPN and ensuring patient safety.