Total Parenteral Nutrition (TPN)
Pneumothorax might
 bypasses the digestive system by the
administration to the bloodstream
1. Subclavian line.
2. Central Venous Catheter.
3. PICC (Peripherally inserted central
catheter) line.
 Infusion pump - the nurse should
prepare an infusion pump prior
hanging a parenteral solution.
 Glucometer is also needed since the
client’s glucose level is monitored
every 4 to 6 hours, but it is not an
essential item needed
 Temperature and weight - monitored
to identify signs of infection which is
one of the complications of this
therapy. While the weight is
monitored to detect hypervolemia
 Thirst, blurred vision, and diuresis.
Signs of hyperglycemia include
excessive thirst, fatigue, restlessness,
blurred vision, confusion, weakness,
Kussmaul’s respirations, diuresis, and
coma when hyperglycemia
 10% dextrose in water - The client is
at risk of hypoglycemia. Hence the
nurse will hang a solution that has the
highest amount of glucose until the
new parenteral nutrition solution
becomes readily available.
 Send them to the laboratory for
culture. When the client who is
receiving PN has a high temperature, a
catheter-related infection should be
suspected
 Allergy to an egg. Fat emulsions
(lipids) contain egg yolk
phospholipids and should not be given
to clients with egg allergies.
 Pneumothorax.
happen during a parenteral therapy due to
inexact catheter placement. In order to
prevent this, the nurse obtains a chest x-
ray after insertion of the catheter to
ensure proper catheter placement.
TUBERCULOSIS
1. Latent Tuberculosis –when the person
who had been exposed to the M.
tuberculosis nuclei does not manifest
signs and symptoms of the disease and do
not have the capacity to infect other
people. Could stay for a long time, not
until that immunosuppression or a certain
factor triggers it to become its Virulent
form.
2. Primary Pulmonary Tuberculosis – It
is usually asymptomatic and only
identified through significant
diagnostic examinations. Only the
presence of lymphadenopathy is
something that is indicative for its
infection.
3. Primary Progressive Tuberculosis –it
is already considered as active. Clinical
manifestations are evident and the client
may reveal positive in sputum
examination for presence of the
organism. Sometimes, he or she may
manifest cough with purulent sputum and
some pleuritic chest pains because of
inflammation in the parenchymal walls.
4. Extra pulmonary Tuberculosis –
Tuberculosis extends its infection to other
parts of the aside from the pulmonary
cavity. The most fatal location is the
central nervous system and its infection
to the bloodstream. Include the lymphatic
system, the bones and joints and at times
the genitourinary system.
 Limit alcohol intake - during drug
therapy. INH and Rifampin are
hepatoxic drugs.
 Both drugs should be taken on an
empty stomach
 If antacids are needed for GI distress,
they should be taken 1 hour before or
2 hours after these drugs are administered.
 DO not double the dosage of these
drugs because of their potential
toxicity.
 Clients taking INH should avoid foods
that are rich in tyramine, such as
cheese and dairy products, or they may
develop hypertension.
 Stage Erik Erikson’s Sigmund Freud Jean Piaget Lawrence
Kohlberg’s
 Psychosocial  Psychosexual  Cognitive  moral
development development development development

Infancy  Trust vs. mistrust  Oral  Sensorimotor

 Feeding (birth to 2 years)
(birth to 1
year)
Toddlerhood  Autonomy vs.  Anal  Sensorimotor (1-  Preconventional
same and doubt 2 years);
(1-3 years old)  Toilet Training preoperational
(preconceptual)
(2-4 years

Preschool  Initiative vs. guilt  Phallic  Preoperational  Preconventional

 Exploration (preconceptual)
(3-6 years old) (2-4 years);
preoperational
(intuitive) (4-7
years)

School Age  Industry vs.  Latency  Concrete  Conventional

inferiority operations
(6-12 years)  School (7-11 years)

Adolescence  Identity vs. role  Genital  Formal  Post

diffusion operations conventional
(12-18 years) (confusion)  (11-15 years)
 Social
Relationships

Young  Intimacy vs.   

Adulthood (19 Isolation
to 40 years)  Relationships

Middle  Generativity vs.   

Adulthood (40 Stagnation
to 65 years)  Work and
Parenthood
Maturity(65 to  Ego Integrity vs.   
death) Despair
 Reflection on
Life