A client is receiving Total Parenteral Nutrition (TPN) while admitted in the inpatient setting. Which of the following conditions can occur if the nurse abruptly stops TPN?
Diarrhea
Hypoglycemia
Hypovolemia
Erythema at the site
The Correct Answer is B
A. Diarrhea is not a direct risk of stopping TPN abruptly.
B. Abruptly stopping TPN can cause hypoglycemia because the high glucose content in TPN leads to increased insulin production. Without the continuous glucose infusion, blood sugar levels can drop rapidly.
C. Hypovolemia is not a common outcome from stopping TPN suddenly.
D. Erythema at the site is unrelated to the cessation of TPN and more commonly related to local site reactions or infection.
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Correct Answer is ["D","E","F"]
Explanation
A. Excessive sweating is not typically associated with anticholinergic medications like scopolamine; in fact, these medications can lead to decreased sweating.
B. Bradycardia can occur with certain medications but is more commonly associated with other drug classes rather than scopolamine, which typically causes tachycardia.
C. Diarrhea is not a common side effect of scopolamine; instead, anticholinergics often cause constipation.
D. Urinary retention is a known side effect of scopolamine due to its anticholinergic properties, which can affect bladder function.
E. Constipation is a common side effect of anticholinergic medications, including scopolamine.
F. Dry mouth is another common side effect due to decreased salivary secretions resulting from anticholinergic activity.
Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.