Fundamentals of Nursing Q 261
A nurse is conducting a follow-up home visit to a client who has been discharged with parenteral nutrition(PN). Which of the following should the nurse most closely monitor in this kind of therapy?
A. Blood pressure and temperature.
B. Blood pressure and pulse rate.
C. Height and weight.
D. Temperature and weight.
Correct Answer: D. Temperature and weight.
The client’s temperature is monitored to identify signs of infection which is one of the complications of this therapy. While the weight is monitored to detect hypervolemia and to determine the effectiveness of this nutritional therapy. Monitoring patients on parenteral nutrition (PN) requires a multidisciplinary approach with effective communication throughout the team. This will help to minimize potential complications and will aid safe, effective, and appropriate use of PN.
Option A: Temperature should be monitored to watch for infection, however, blood pressure is not as important during total parenteral nutrition. But blood pressure should still be monitored routinely. The risk of infectious complications is increased due to venous access for PN. The likelihood of hyperglycemia-induced complications may depend on concomitant diseases, duration of PN, and life expectancy.
Option B: Blood pressure and pulse rate may be checked routinely in a patient with TPN. Efficient monitoring in all types of PN can result in reduced PN-associated complications and reduced costs. Water and electrolyte balance, blood sugar, and cardiovascular function should regularly be monitored during PN.
Option C: Monitoring the patient’s height is not necessary during TPN administration. Nutritional status is most effectively assessed and monitored through a combination of anthropometric data, biochemical and clinical measures. A stand-alone measure e.g. weight can rarely provide adequate information.