Final answer:
The nurse should educate the patient to monitor for signs of infection at the central line site, such as redness or swelling. Correct tube changing frequency will vary, rapid infusion of TPN is incorrect, and TPN should be administered at room temperature to avoid discomfort.
Step-by-step explanation:
The nurse should include a variety of critical care practices when instructing a patient newly prescribed to total parenteral nutrition (TPN) through a central line. Among the options provided, the correct instruction would be to monitor for signs of infection, such as redness or swelling at the insertion site. This is essential because infections at the central line site can lead to serious complications as seen in Barbara's case, where she displayed signs of infection and was treated with antibiotics.
It is important to change the tubing regularly; however, the specific frequency can be based on hospital protocol or physician's orders and may not be exactly every 48 hours. Infusing the solution rapidly is incorrect, as TPN solutions should be infused at a controlled rate to prevent complications like hyperglycemia or fluid overload. Administering chilled solutions can cause hypothermia or discomfort, so administering TPN at room temperature is indeed good practice to prevent discomfort.
In regard to the severity of infections in central venous catheters, Dr. Pronovost introduced a checklist to decrease the rates of infection, which emphasizes the importance of structured protocols. It is critical to maintain aseptic technique throughout the process and follow strict guidelines for the care and maintenance of central lines to prevent infections, which are potentially life-threatening complications.