Final answer:
The nurse should administer TPN with the prescribed glucose monitoring, which includes checking blood glucose levels before meals and at bedtime. Insulin injections can be used to manage elevated blood glucose levels in patients receiving TPN.
Step-by-step explanation:
The correct action the nurse should take when reviewing the chart for a client who is receiving total parenteral nutrition (TPN) and is NPO with a prescription for capillary blood glucose AC and HS is d) Administer TPN with the prescribed glucose monitoring. This prescription indicates that the nurse should monitor the blood glucose levels before meals (AC) and at bedtime (HS). Insulin may be administered if the glucose level is elevated, according to the patient's specific protocol for managing blood sugars while on TPN, which often includes insulin administration because TPN solutions are typically high in glucose. Withholding TPN if the glucose level is below normal would not be appropriate, as TPN is the patient's primary nutrition source. Instead, alterations to glucose management should be made in collaboration with the healthcare team.
Insulin injections are typically utilized to decrease blood glucose levels when they are elevated, such as after consuming a high-glucose meal. However, insulin and glucagon play a critical role in maintaining blood glucose homeostasis, with insulin decreasing and glucagon increasing blood glucose levels.