DSSSB 14 August 2024
Medical & Surgical Nursing
Medium
Which kit is shown in the given image? 
Appeared in: DSSSB 14 August 2024
Explanation
- The image shows a TPN kit, identified by the large IV bag containing a milky, opaque fluid.
- This milky appearance is characteristic of a lipid emulsion, which is a component of a 3-in-1 TPN solution.
- TPN, or Total Parenteral Nutrition, is administered intravenously, which is consistent with the IV bag and tubing shown.
- The purpose of TPN is to provide complete nutritional support to patients who cannot use their gastrointestinal tract.
Why Other Options Were Wrong
- Option B: A gastric gavage kit is for enteral feeding (into the stomach), not intravenous feeding. The equipment and administration route are different.
- Option C: A Ryle's tube-feeding kit is a specific type of enteral feeding system. It involves a nasogastric tube for feeding into the stomach, not an IV line.
- Option D: A gastric lavage kit is used to wash out the stomach, typically in cases of poisoning. It uses large volumes of clear fluid (like saline), not a milky nutritional solution.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of medical nutrition therapy equipment as background academic context rather than a clinical decision trigger.
- Correctly identifying infusion types is a critical patient safety skill for nurses. Administering an enteral formula intravenously is a 'never event' and can be fatal.
- Nurses must always trace lines from the bag to the patient insertion site before starting any infusion to prevent misconnections.
- What if the fluid in the bag was clear? It could be a 2-in-1 TPN solution (dextrose and amino acids, with lipids given separately) or another IV fluid. The nurse's primary responsibility would be to read the label on the bag to confirm its contents and compare it with the physician's order before administration.
How to Approach the Question
- First, carefully analyze the image provided. Identify the key objects and their characteristics. In this case, note the IV bag, the tubing, and the milky white color of the fluid.
- Consider the term 'kit' and what each option implies. A 'kit' refers to a set of equipment for a specific procedure.
- Evaluate Option A (TPN kit). Recall that TPN can contain lipids, giving it a milky appearance, and is administered intravenously. This matches the visual evidence.
- Evaluate Option B and C (Gastric gavage/Ryle's tube). These are for enteral feeding into the stomach. This is inconsistent with the IV bag shown.
- Evaluate Option D (Gastric lavage). This is for stomach washing and uses clear fluids, not a milky nutritional formula.
- Conclude that the visual evidence most strongly supports the identification of a TPN kit.
Concept Tested & Keywords
- Concept Tested: Identification of medical nutrition therapy equipment
- Stem keywords: kit, image
- Lead-in keywords: Which
- Clinical cues: The milky white appearance of the fluid in the IV bag is the primary clinical cue, indicating a lipid emulsion.
Question ID
Q9OxrwClr2sXiMygJI_gm9
Reference Book
E6 Nursing Fundamentals Taylor pp. 518-520, 517-519
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 205-207
Practise the full DSSSB 14 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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