IV IV Nutrition & Blood Products 2

Question 1

What is 'refeeding syndrome' and when is it most likely to occur with TPN?

Accepted Answer

Dangerous electrolyte shifts (especially hypophosphatemia) when nutrition is reintroduced to severely malnourished patients

Answer

Refeeding syndrome occurs when malnourished patients receive TPN, causing rapid intracellular phosphate shifts that result in life-threatening hypophosphatemia, hypokalemia, and hypomagnesemia.

Question 2

A patient receiving TPN develops a fever, chills, and elevated WBC. The TPN bag appears cloudy. What is the most appropriate action?

Accepted Answer

Discontinue the TPN infusion, retain the bag for culture, and insert a new IV with fresh TPN after physician evaluation

Answer

A cloudy TPN bag with systemic signs of infection suggests contamination; the infusion must be stopped, the bag retained for culture, and new TPN obtained after medical evaluation.

Question 3

What is the primary purpose of lipid emulsions in total parenteral nutrition?

Accepted Answer

To supply essential fatty acids and a concentrated caloric source for energy

Answer

Lipid emulsions in TPN provide essential fatty acids (linoleic and linolenic acid) and a calorie-dense energy source that reduces dextrose load and prevents essential fatty acid deficiency.

Question 4

Febrile non-hemolytic transfusion reaction (FNHTR) is caused by which mechanism?

Accepted Answer

Recipient antibodies reacting against donor leukocytes and cytokines in the blood product

Answer

FNHTR is caused by recipient antibodies directed against donor white blood cell antigens and/or cytokines accumulated during storage, producing fever and chills without hemolysis.

Question 5

A patient has an order for 2 units of fresh frozen plasma (FFP). The nurse knows that FFP must be transfused within how many hours of thawing?

Accepted Answer

24 hours

Answer

Thawed FFP must be transfused within 24 hours (some institutions allow thawed plasma within 5 days) to preserve coagulation factor activity.

(IV) Intravenous Therapy Certified Practice Test

(IV) Intravenous Therapy Certified Practice Test

IV IV Nutrition & Blood Products 2