NCLEX-PN® ExaminationPharmacological TherapiesMedium
A client is receiving total parenteral nutrition (TPN) via a central venous catheter. The LPN observes that the TPN solution bag is almost empty, and the new bag is not yet available from the pharmacy. What is the most appropriate immediate action for the LPN to take?
- AStop the TPN infusion and wait for the new bag to arrive.
- BIncrease the infusion rate of the remaining TPN to prolong its use.
- CHang a bag of D5W (5% Dextrose in Water) at the prescribed TPN rate.
- DHang a bag of D10W (10% Dextrose in Water) at the prescribed TPN rate.
Show answer & explanationAnswer & explanation
Correct answer: D. Hang a bag of D10W (10% Dextrose in Water) at the prescribed TPN rate.
If TPN is interrupted and a new bag is unavailable, a temporary infusion of D10W (10% Dextrose in Water) should be initiated. TPN solutions are high in glucose, and abrupt cessation can lead to rebound hypoglycemia. D10W provides sufficient glucose to prevent this complication.
Why the other options are wrong
- A. Stopping the TPN infusion without providing an alternative glucose source will put the client at risk for severe rebound hypoglycemia.
- B. Increasing the infusion rate of the remaining TPN could lead to fluid overload or hyperglycemia and will not solve the underlying issue of an empty bag.
- C. D5W does not provide enough glucose to prevent rebound hypoglycemia when TPN is abruptly stopped.
TPN Interruption Management
Interventions to prevent complications, primarily rebound hypoglycemia, when total parenteral nutrition (TPN) infusion is unexpectedly interrupted.
- Never abruptly stop TPN.
- Hang D10W if new TPN is unavailable.
- Monitor blood glucose closely.
Memory trick: TPN's Gone? D10W to the Rescue, or Hypoglycemia will Pursue!