Final answer:
Rebound hypoglycemia occurs when total parenteral nutrition (TPN) is discontinued without tapering. It results from the continued action of insulin on blood glucose after the external glucose source from TPN stops, leading to a rapid drop in blood sugar levels.
Step-by-step explanation:
When administering total parenteral nutrition (TPN), the nurse should assess the client for signs of rebound hypoglycemia. The nurse knows that rebound hypoglycemia occurs when the infusion is discontinued without tapering. This situation can lead the pancreas to release insulin in response to high blood glucose levels during TPN infusion. However, once the infusion stops abruptly without a gradual decrease, insulin levels may stay temporarily high even when there isn't an external source of glucose from the infusion, which might lead to hypoglycemia.
Understanding the balance between insulin and glucagon is crucial in this context. During the postabsorptive state, as food has been digested, absorbed, and stored, the body's glucose levels start to drop, leading to a decrease in insulin release and an increase in glucagon release. Glucagon acts on the liver cells to release glucose to maintain adequate blood glucose levels. In the case of sudden cessation of TPN, the insulin still present in the body can continue to lower blood glucose after the external glucose source from TPN is removed, potentially causing rebound hypoglycemia.