Parenteral Nutrition Administration Flashcards
7 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Parenteral Nutrition Administration flashcards as text
A patient receiving PN develops sudden onset chest pain, hypotension, and cyanosis shortly after the infusion begins. The nurse should first suspect:
Answer: Air embolism
Air embolism is a life-threatening complication of PN that presents with sudden chest pain, hypotension, and cyanosis, requiring immediate intervention including placing the patient in left lateral Trendelenburg position.
Which electrolyte abnormality is MOST associated with refeeding syndrome in a severely malnourished patient starting PN?
Answer: Hypophosphatemia
Hypophosphatemia is the hallmark of refeeding syndrome, occurring as insulin shifts phosphate intracellularly when carbohydrate metabolism resumes after prolonged starvation.
When using a 1.2-micron in-line filter for PN administration, the nurse understands this filter is appropriate for:
Answer: Total nutrient admixtures (3-in-1)
A 1.2-micron filter is used for total nutrient admixtures (3-in-1) because it allows lipid particles to pass through while filtering particulates and some microorganisms.
A CRNI is calculating the osmolarity of a peripheral PN solution. Which finding would indicate it is safe for peripheral administration?
Answer: 900 mOsm/L
Peripheral PN should not exceed 900 mOsm/L to minimize the risk of phlebitis and vein damage.
Which action is correct when a PN bag must be changed before it is completely infused?
Answer: Discard the remaining solution and hang the new bag
Partially infused PN bags should be discarded because PN is an ideal growth medium for microorganisms and must not be stored after being spiked.
A patient's PN infusion is 4 hours behind schedule. The nurse should:
Answer: Continue the infusion at the prescribed rate and notify the provider
PN should never be infused faster than prescribed to avoid hyperglycemia and metabolic complications; the nurse should continue at the ordered rate and notify the provider.
During PN administration via a PICC, the nurse notes the patient's arm is swollen and the infusion rate has slowed. The MOST appropriate action is:
Answer: Stop the infusion and assess for PICC tip migration or extravasation
Swelling and decreased flow rate suggest possible PICC migration or extravasation, and infusing PN into tissue can cause serious necrosis.