A nurse is teaching a patient who will be going home with TPN. Which information would the nurse need to include when teaching this patient about home TPN use? Select all that apply.

 

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Correct

- Always wash hands and the work area before changing TPN solution

- Warm the TPN bag in the microwave shortly before infusing

- If particles are noted in the bag, gently rotate the bag to dissolve them

- Monitor blood glucose levels and promptly report any abnormalities

- Record a weight in the same clothes at the same time each day

Rationale

-"Always wash hands and the work area before changing TPN solution", "Monitor blood glucose levels and promptly report any abnormalities" and "Record a weight in the same clothes at the same time each day" are correct. It is common for a patient to be discharged from the hospital while still requiring a daily TPN infusion. In order for them to be successful with TPN in the home, the nurse educates the patient regarding home care instructions. The patient and/or caregiver will need to learn how to use the pump, change a sterile dressing, obtain a daily weight, report a weight gain of more than three pounds in a week, monitor blood glucose levels and the signs of hyper/hypoglycemia, and how to detect infection/thrombosis/catheter displacement. Any time the patient has a question they are encouraged to call their health care provider as well.
-"Warm the TPN bag in the microwave shortly before infusing" is incorrect because microwaving the solution will change the components. NEVER microwave the TPN solution. Instead, it can be brought to room temperature by removing the bag from the refrigerator 4-6 hours before administration OR placing the bag under warm (not hot) running water.
-"If particles are noted in the bag, gently rotate the bag to dissolve them" is incorrect. If there are particles noted in the bag, the bag is considered contaminated. A new bag must be obtained.

References:
Silvestri, L. A. (2017). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier

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Question ID - 16091

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