33. The patient is having at least 75% of nutritional needs met by enteral feeding, so the health care

provider has ordered the parenteral nutrition (PN) to be discontinued. However, the nurse notices that

the PN infusion has fallen behind. What should the nurse do?

a. Increase the rate to get the volume caught up before discontinuing.

b. Stop the infusion as ordered.

c. Taper infusion gradually.

d. Hang 5?xtrose.

ANS: C

Sudden discontinuation of PN can cause hypoglycemia. PN must be tapered off. Usually, 10?xtrose is

infused when PN solution is suddenly discontinued. Too rapid administration of hypertonic dextrose (PN) can

result in an osmotic diuresis and dehydration. If an infusion falls behind schedule, the nurse should not

increase the rate in an attempt to catch up.

34. The patient is on parenteral nutrition and is lethargic. The patient reports thirst and headache and

has had increased urination. Which problem does the nurse prepare to address?

a. Hyperglycemia

b. Hypoglycemia

c. Hypercapnia

d. Hypocapnia

ANS: A

Signs and symptoms of hyperglycemia are thirst, headache, lethargy, and increased urination. Hypocapnia is

not associated with parenteral nutrition. Hypercapnia increases oxygen consumption and increases CO2 levels.

Ventilator-dependent patients are at greatest risk for this. Hypoglycemia is characterized by diaphoresis,

shakiness, confusion, and loss of consciousness.

35. In providing diabetic teaching for a patient with type 1 diabetes mellitus, which instructions will the

nurse provide to the patient?

a. Insulin is the only consideration that must be taken into account.

b. Saturated fat should be limited to less than 7% of total calories.

c. Nonnutritive sweeteners can be used without restriction.

d. Cholesterol intake should be greater than 200 mg/day.

ANS: B

The diabetic patient should limit saturated fat to less than 7% of total calories and cholesterol intake to less

than 200 mg/day. Type 1 diabetes requires both insulin and dietary restrictions for optimal control.

Nonnutritive sweeteners can be eaten as long as the recommended daily intake levels are followed.

36. The patient with cardiovascular disease is receiving dietary instructions from the nurse. Which

information from the patient indicates teaching is successful?