A nurse conducting rounds checks on a client receiving continuous total parenteral nutrition (TPN). The infusion pump is found to be powered down, and TPN is no longer infusing. Which action should the nurse take first?

Question

Quizplus · Accepted Answer

Total parenteral nutrition (TPN) is an IV nutrition solution containing carbohydrates, amino acids, vitamins, minerals, electrolytes, and lipids that is administered to clients who are unable to receive enteral nutrition. TPN is rich in glucose, which supplies caloric energy and stimulates the pancreas to secrete insulin. If TPN is stopped abruptly, the pancreas may continue to secrete increased amounts of insulin in anticipation of glucose metabolism, placing the client at risk for rapid-onset hypoglycemia. Therefore, clients whose TPN infusion has stopped or abruptly slowed should be assessed for signs of hypoglycemia and have blood glucose measured immediately, because hypoglycemia is associated with potentially life-threatening neurologic complications (Option C). (Option A) The nurse must notify the health care provider to obtain appropriate prescriptions for intervention and monitoring. However, the nurse should first ensure the client's safety by assessing for hypoglycemia. (Option B) Obtaining a serum electrolyte panel may be necessary to identify electrolyte abnormalities. However, the nurse must first assess for hypoglycemia because this will occur more rapidly than changes in electrolyte status. (Option D) Removal, identification, and storage of defective equipment are important to prevent future adverse events. However, the nurse should assess and stabilize the client before handling malfunctioning equipment. Educational objective: Total parenteral nutrition (TPN) is a nutritional IV solution that is rich in glucose. Clients whose TPN delivery has stopped abruptly are at risk for severe hypoglycemia due to increased pancreatic insulin production; therefore, the nurse should promptly assess the client for hypoglycemia.

A Nurse Conducting Rounds Checks on a Client Receiving Continuous