Neonatal Nurse Practitioner Practice Exam

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When caring for an infant on total parenteral nutrition, which statement is correct regarding dextrose concentration?

A dextrose concentration of 5% or less requires a central line
A dextrose concentration of 10% or greater can be used peripherally
A dextrose concentration of 15% or greater requires a central line
A dextrose concentration of 12.5% or greater requires a central line

The correct answer is: A dextrose concentration of 12.5% or greater requires a central line

In the context of caring for an infant on total parenteral nutrition, it is important to consider the concentration of dextrose when determining the appropriate type of intravenous access. A dextrose concentration of 12.5% or greater is associated with a higher risk of thrombophlebitis and damage to the peripheral veins due to irritation from the hypertonic solution. Therefore, such concentrations are typically delivered via a central line, which offers a larger and more stable vessel for the infusion, reducing the risk of complications. Utilizing a central line for dextrose concentrations of 12.5% or higher ensures that the solution can be effectively delivered into a larger blood vessel, allowing for more rapid dilution and minimizing the risk to peripheral veins. This practice enhances patient safety and ensures that the infant receives the necessary nutritional support while reducing the likelihood of vascular complications associated with high concentrations of dextrose.