Question

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new bag is not available when the current infusion is nearly completed. Which of the following actions should the nurse take?

A. Keep the line open with 0.9% sodium chloride until the new bag arrives.
B. Administer dextrose 10% in water until the new bag arrives.
C. Flush the line and cap the port until the new bag arrives.
D. Decrease the infusion rate until the new bag arrives.

Answer 1

When a new TPN bag is unavailable and the current infusion is almost complete, the best course of action is to maintain the line with 0.9% sodium chloride to prevent hypoglycemia and keep the vein open.

Step-by-step explanation:

If a nurse is caring for a client who is receiving total parenteral nutrition (TPN) and a new bag is not available when the current infusion is nearly completed, the recommended action is to keep the line open with 0.9% sodium chloride until the new bag arrives. This is because sudden discontinuation of TPN can lead to hypoglycemia due to the pancreas secreting insulin for the high dextrose concentration in TPN. Option A, therefore, is the best practice as it prevents hypoglycemia by maintaining a baseline infusion and keeps the vein open for the next TPN infusion. Options B, while not ideal, is a viable temporary alternative if standard saline is not available, as dextrose 10% in water can also help prevent hypoglycemia. Option C is not recommended in this case as it involves interrupting the TPN therapy which could lead to complications, and option D could also lead to hypoglycemia since it just reduces the rate at which TPN is administered, without providing an alternative source of glucose.