The LPN/LVN cares for a client receiving the second day of total parenteral nutrition (TPN). The nursing assistant reports to the LPN/LVN that the client is having difficulty breathing. Which of the following actions should the LPN/LVN take FIRST?
a. Lower the head of the bed and decrease the TPN rate.
b. Ask the nursing assistant if dyspnea occurred during ambulation.
c. Assess peripheral pulse proximal to the IV site.
d. Auscultate lungs and review intake/output records.

The correct answer is - option d.

Explanation:

The client is having the breathing problem in this case, such respiratory congestion is often lead by the fluid overload especially in the case of TPN. Record of the input and output would be helpful in determining LPN/LVN if the client is suffering from the over-hydration.

Raising head will decrease the breathing in the client. Undiagnosed dyspnea or case of dyspnea would not affect the circulation in upper limb but effect would be center of the body.

Thus, The correct answer is - option d.