Ch: 14 Lesson Questions

Which patient parameters would a nurse ensure are documented in order to determine the appropriate dosage requirements for a patient who will be receiving parenteral nutrition? a. Age b. Gender c. Weight d. Blood pressure e. Overall condition

a. Age The patient's age should be documented because it is important for determination of appropriate nutritional intake. b. Gender The patient's gender is important to document because it is used for dosage requirements of parenteral nutrition. c. Weight The patient's weight should be verified and documented because it is used for dosage requirements of parenteral nutrition. e. Overall condition The overall condition of the patient should be determined because this will influence dosage requirements of parenteral nutrition.

Which phrases about enteral nutrition are accurate? a. Can help to meet total nutrient requirements b. Can be used for both short and prolonged periods of time c. Describes a method of feeding when nutrients are intravenously administered d. Can reduce costs for treating infections, wound healing, and length of hospital stay e. Is considered the best method for feeding a patient who cannot eat by mouth and does not have a functioning gut

a. Can help to meet total nutrient requirements Enteral nutrition is used to meet total nutrient requirements, particularly in patients who cannot eat and do not have a functioning gastrointestinal system. b. Can be used for both short and prolonged periods of time Enteral nutrition can be used for a short period of time and chronically in those who require it. d. Can reduce costs for treating infections, wound healing, and length of hospital stay Enteral nutrition may be helpful to reduce costs associated with treating infections, wound healing, and length of stay in the hospital.

Which of the following are recognized as metabolic complications associated with tube feedings? a. Dehydration b. Pressure necrosis c. Glucose intolerance d. Refeeding syndrome e. Aspiration of the formula f. Diarrhea due to bacterial overgrowth

a. Dehydration Dehydration can cause fluid and electrolyte imbalances and is considered a metabolic complication of tube feeding. c. Glucose intolerance Glucose intolerance is considered a metabolic complication of tube feeding. d. Refeeding syndrome Refeeding syndrome may occur in patients who have not eaten for an extended period of time and may pose a risk and cause depressed levels of electrolytes. This is a metabolic complication of tube feeding.

Which statements about parenteral nutrition components are accurate? a. Fats are provided as lipid emulsions. b. Protein is provided as crystalline amino acids. c. Carbohydrates are provided as dextrose monohydrate. d. Both essential and nonessential amino acids are included in parenteral nutrition. e. Vitamin content varies based on patient needs, and there are preparations available that differ in regard to inclusion of vitamin B12. f. Trace elements included in standard parenteral nutrition are chromium, copper, manganese, zinc, and selenium.

a. Fats are provided as lipid emulsions. Fats in parenteral nutrition are provided as lipid emulsions, made of aqueous suspensions of soybean oil with egg yolk phospholipids as the emulsifier. They come in varying concentrations. b. Protein is provided as crystalline amino acids. Protein comes in the form of crystalline amino acids. c. Carbohydrates are provided as dextrose monohydrate. Dextrose monohydrate is the form of carbohydrate used in parenteral nutrition. d. Both essential and nonessential amino acids are included in parenteral nutrition. Parenteral nutrition contains all essential and some nonessential amino acids. f. Trace elements included in standard parenteral nutrition are chromium, copper, manganese, zinc, and selenium. Chromium, copper, manganese, zinc, and selenium are the trace elements that are included in standard parenteral nutrition solutions.

Which statements by the nurse about catheter use for parenteral feeding are accurate? a. Infections may occur from catheter seeding. b. The use of a catheter can lead to the development of pressure necrosis. c. The use of external clamps may cause nonthrombotic occlusions with the catheter. d. Fibrin sleeve formation is an example of a thrombotic occlusion that may occur with the catheter. e. Catheter patency is determined by the ability to infuse the parenteral nutrition and aspirate blood without resistance.

a. Infections may occur from catheter seeding. Infections associated with catheters may be due to catheter seeding, the catheter entrance site, bloodborne or distant infection, contamination from insertion, or from contamination of the parenteral nutrition solution. c. The use of external clamps may cause nonthrombotic occlusions with the catheter. External clamps, mechanical occlusion from kinking of the catheter, and occluded port needles are nonthrombotic causes of catheter occlusions. d. Fibrin sleeve formation is an example of a thrombotic occlusion that may occur with the catheter. Fibrin sleeve formation, thrombosis, and intraluminal clots are examples of thrombotic occlusions of the catheter. e. Catheter patency is determined by the ability to infuse the parenteral nutrition and aspirate blood without resistance. The ability to infuse the parenteral nutrition and aspirate blood without resistance determines the catheter's patency.

Which parameters would a nurse monitor in a patient who is receiving enteral feedings? a. Liver function b. Albumin levels c. Thyroid function d. Electrolyte levels e. Triglyceride levels f. Patient intake and output

a. Liver function The patient's hepatic function should be monitored while receiving enteral nutrition. b. Albumin levels The patient's albumin and prealbumin levels should be monitored while receiving enteral nutrition. d. Electrolyte levels Electrolyte levels should be closely monitored in patients receiving enteral therapy. e. Triglyceride levels Serum triglyceride levels should be monitored in patients receiving enteral therapy. f. Patient intake and output The intake and output of the patient is important to monitor while receiving enteral therapy.

Match the route for enteral feeding with its location. a. Inserted through nares, terminating in stomach b. Inserted through nares, passing through and terminating after stomach c. Inserted surgically or endoscopically directly into stomach through abdomen d. Inserted surgically or endoscopically near the small bowel through abdomen

a. Nasogastric b. Nasoduodenal/Nasojejunal c. Gastrostomy d. Jejunostomy

Which statement about parenteral nutrition is accurate? a. Peripheral parenteral nutrition is used for patients for a short period of time. b. Central parenteral nutrition is used for patients who can tolerate high fluid volumes. c. Peripheral parenteral nutrition can support an osmolarity of greater than 900 mOsm/L. d. Central parenteral nutrition is used for patients who have minimal nutritional requirements.

a. Peripheral parenteral nutrition is used for patients for a short period of time. Peripheral parenteral nutrition is intended for use over a short period of time.

Which parameters would a nurse monitor in a patient who is receiving parenteral feedings? a. Weight b. Renal function c. Blood pressure d. Liver function tests e. Fluid requirements f. Serum glucose levels

a. Weight The patient's weight should be monitored while receiving parenteral feedings. b. Renal function The patient's renal function should be monitored while receiving parenteral feedings. d. Liver function tests The patient's hepatic function as measured by liver function tests should be monitored while receiving parenteral feedings. e. Fluid requirements The patient's fluid requirements should be monitored while receiving parenteral feedings. f. Serum glucose levels The glucose levels of the patient should be monitored while receiving parenteral feedings.

Match the type of enteral nutrition with its description. a. Contain intact nutrients such as casein for use with a functioning GI tract b. Contain partially or completely hydrolyzed nutrients that readily absorb c. Single nutrients added to feeding regimen as needed d. Food items mixed together

a. polymeric formulas b. elmental formulas c. modular formulas d. blenderized/ homemade formulas

Which patients would be candidates for receiving parenteral nutrition? a. A patient who is tolerating liquids b. A patient who requires bowel rest c. A patient who continues to pull out the feeding tube d. A patient who does not have access for a feeding tube e. A patient whose nutritional needs have not been met after 10 days of enteral nutrition

b. A patient who requires bowel rest A patient who requires bowel rest would be an appropriate candidate for parenteral nutrition. c. A patient who continues to pull out the feeding tube A patient who continues to pull out the feeding tube would be an appropriate candidate for parenteral nutrition because the enteral tube cannot remain in place for enteral feedings. d. A patient who does not have access for a feeding tube A patient who does not have access for a feeding tube would be an appropriate candidate for parenteral nutrition. e. A patient whose nutritional needs have not been met after 10 days of enteral nutrition A patient whose nutritional needs have not been met after 10 days of enteral nutrition would be an appropriate candidate for parenteral nutrition.

Which nursing interventions may be offered to a patient who has tube discomfort with enteral feeding? a. Request a larger tube. b. Warm the feedings for the patient. c. Clean the tube regularly with water. d. Use continuous versus bolus feeding. e. Have the patient gently blow his or her nose.

c. Clean the tube regularly with water. Cleaning the tube regularly with water can help alleviate tube discomfort associated with enteral feeding. e. Have the patient gently blow his or her nose. Having the patient gently blow the nose can help alleviate tube discomfort associated with enteral feeding.

Which nursing interventions may be offered to a patient who is experiencing diarrhea from receiving enteral feeding? a. Increase sorbitol administration. b. Chill the feedings before administration. c. Evaluate the patient for lactose intolerance. d. Use continuous feedings as opposed to bolus feedings. e. Administer antidiarrheal medication as prescribed.

c. Evaluate the patient for lactose intolerance. Evaluation for lactose intolerance may be suggested for a patient who has diarrhea with enteral feeding. d. Use continuous feedings as opposed to bolus feedings. Continuous feedings may help to minimize diarrhea as opposed to bolus dosing of enteral feedings. e. Administer antidiarrheal medication as prescribed. Antidiarrheal medications may be administered to minimize diarrhea from enteral feeding.

A nurse is caring for a patient receiving parenteral nutrition who has developed swelling in the ankles and has crackles upon inhalation. Which complication of nutritional supplemental therapy does a nurse suspect may be occurring? a. Aspiration b. Extravasation c. Fluid overload d. Catheter-related infection

c. Fluid overload Fluid overload is characterized by signs of fluid overload such as edema and lung crackles. It may occur in patients who have not eaten for an extended period of time.