AH1 TPN & PEG practice Q's
How many hours will the bag of lipids infuse over?
12 - 24 hours
How long with the TPN tubing good for before the nurse must change it?
24 hours
How many hours will a bag of TPN infuse over?
24 hours
A patient with difficulty swallowing is started on continuous tube feedings of a full-strength commercial formula at 100 ml/hr. The patient has six diarrhea stools the first day. Which action is most appropriate for the nurse to take first? A. Slow the tube feeding flow rate. B. Discontinue any water intake. C. Notify the health care provider about the need for a change in formula. D. Check residuals and hold feedings if any residual is found.
A
Which patient would be an candidate for TPN? Select all that apply A. Chronic severe or intractable diarrhea and vomiting B. GI obstruction C. Dysphagia D. Severe mal-absorption E. Colitis
A, B, D
A patient is started on TPN for severe anorexia. Which order is appropriate for this patient? A. Accucheck ac and hs B. Accucheck every 6 hours C. No need for accucheck D. Lantus q hs
B
A patient who has dysphagia as a consequence of a stroke is receiving enteral feedings through a percutaneous endoscopic gastrostomy (PEG). Which of the following interventions should the nurse integrate into this patient's care? A. Flush the tube with 30 ml of normal saline every 4 hours. B. Flush the tube before and after feedings if the patient's feedings are intermittent. C. Flush the PEG with 100 ml of sterile water before and after medication administration. D. To prevent fluid overload, avoid flushing when the patient is receiving continuous feeding.
B
TPN with a peripherally inserted central catheter (PICC) is initiated for a patient. After 6 hours of PN infusion, the nurse checks the patient's capillary blood glucose level and finds it to be 140 mg/dl (8.9 mmol/L). The most appropriate action by the nurse is to: A. Notify the health care provider of the glucose level. B. Recheck the capillary blood glucose in 4 hours. C. Obtain a venous blood glucose specimen. D. Slow the infusion rate of the TPN infusion.
B
The nurse is schedule to administer TPN. Which is the correct nursing action? A. Administer TPN on the pump with regular tubing. B. Administer via the pump tubing with a filter. C. Administer the TPN by using the gtt factor method. D. Administer the TPN via the peg tube.
B
Which of the following assessments should the nurse prioritize in the care of a patient who has recently begun receiving parenteral nutrition (TPN)? A. Skin integrity and bowel sounds B. Electrolyte levels and daily weights C. Auscultation of the chest and tests of blood coagulability D. Peripheral vascular assessment and level of consciousness (LOC)
B
Why does the nurse have to change the tubing?
Bacteria accumulating
A patient is receiving continuous tube feedings through a percutaneous endoscopic gastrostomy (PEG). To maintain safe and effective delivery of the tube feeding, which action by the nurse is most appropriate? A. Flush the tube with 50 ml of water every 8 hours after checking for residual volume. B. Obtain a daily radiograph for verification of tube placement. C. Check tube placement and residual volume every 4 - 6 hours. D. Place the patient on the left side with the head of the bed elevated to 45 degrees.
C
The nurse assumes care of a patient with a peg tube. The physician orders Jevity 1.5 calories 1 can every 6 hours. Which action by the nurse is correct? A. Place Jevity in a feeding tube to gravity. B. Use a kangaroo pump to administer the proper amount. C. Bolus by gravity one can every 6 hours . D. Clarify this order with the MD.
C
TPN can be infused in either a peripheral line or a central line?
Yes and no since both require different TPN formulas.