AIIMS Delhi NO- 2019
Medical & Surgical Nursing
Easy
Identify the following procedure which nurse is doing in following image:
Appeared in: AIIMS Delhi NO- 2019
Explanation
- The procedure shown involves Total Parenteral Nutrition (TPN).
- The key visual identifier is the distinct yellow color of the fluid, which is caused by the addition of multivitamins (specifically B-complex vitamins) to the solution.
- TPN bags are large, specially compounded in a pharmacy, and feature a detailed label listing all components, which is consistent with the bag shown in the image.
- TPN is a method of providing complete nutrition intravenously, bypassing the digestive system for patients who cannot eat or absorb nutrients.
Why Other Options Were Wrong
- Option B: Dialysis solutions (dialysate) used for peritoneal dialysis are clear and colorless. Hemodialysis is a different procedure that involves an external machine to filter blood.
- Option C: Standard intravenous hydration fluids, such as Normal Saline or Lactated Ringer's, are clear and colorless. They do not have the yellow tint seen in the image.
- Option D: Lavage solutions, which are used for irrigation or washing out body cavities (e.g., gastric lavage), typically consist of sterile water or saline and are clear and colorless.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Identification of intravenous solutions based on visual characteristics to guide bedside assessment, documentation, and the next nursing action.
- Nurses must be able to visually identify IV solutions as a crucial final safety check before administration to prevent potentially fatal medication errors.
- TPN is considered a high-alert medication. It requires a double-check verification by two nurses and vigilant monitoring for complications like hyperglycemia, electrolyte imbalances, and central line-associated bloodstream infections (CLABSI).
- What if? - If the TPN solution appeared milky white instead of yellow, it would likely be a '3-in-1' or 'total nutrient admixture' containing lipids mixed in. If it had visible precipitates, an oily layer, or signs of separation, it would be unsafe to administer and must be returned to the pharmacy.
How to Approach the Question
- This is an image-based identification question, requiring you to recognize a clinical procedure from a visual cue.
- First, carefully analyze the image for key features. The most prominent feature here is the yellow-colored fluid inside a large intravenous bag with a detailed label.
- Next, consider the options provided and evaluate each one based on your visual analysis.
- Recall or deduce the typical appearance of each solution: TPN with multivitamins is characteristically yellow. Dialysis, standard hydration, and lavage solutions are typically clear and colorless.
- Based on the distinct yellow color, eliminate the other options.
- Conclude that the procedure must be related to Total Parenteral Nutrition (TPN).
Concept Tested & Keywords
- Concept Tested: Identification of intravenous solutions based on visual characteristics.
- Stem keywords: procedure, nurse, image
- Lead-in keywords: Identify
- Clinical cues: Yellow fluid in IV bag
- Clinical cues: Compounded pharmacy label
Question ID
QtSVwu5krxM_Ovg39ckT6s
Reference Book
E6 Nursing Fundamentals Taylor pp. 518-520, 793-795
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 67-69
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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