The patient with chronic alcoholism begins parenteral nutrition (PN) at a rate of 50 mL/h for treatment of severe malnutrition. Four hours after the infusion begins, the patient’s urine output increases from 40 mL/h to 200 mL/h. The nurse contacts the provider to request which order?

Administer continuous insulin infusion. Hyperglycemia is a known side effect of parenteral nutrition (PN); polyuria most likely indicates hyperglycemia in this patient. A continuous insulin infusion manages the hyperglycemia while maximizing the nutrition provided to the patient. The PN is running at a rate of 50 mL/h; the urine output far surpasses the intake. Decreasing the rate is not the best intervention to manage the hyperglycemia. Monitoring serum electrolytes is important but does not manage the hyperglycemia. Increasing the sodium concentration of the PN may be necessary but hyperglycemia is more likely than hyponatremia.

The patient with chronic alcoholism begins parente...

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Pharmacological and Parenteral Therapies
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Category: Pharmacological and Parenteral Therapies
Difficulty: 10

Topics: Elimination Endocrine Fluid and Electrolytes Medication and Blood Products Routes of Administration

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