A nurse is caring for a client who is receiving continuous total parenteral nutrition (TPN) via a peripherally inserted central catheter (PICC). Which of the following nursing actions are appropriate for managing this client's parenteral therapy? Select all that apply.
- Replace the TPN solution bag and the intravenous administration tubing every 24 hours.Answer
- Keep a bag of 10% dextrose in water (D10W) readily available in case the TPN infusion is abruptly interrupted.Answer
- Assess the client's capillary blood glucose levels every 4 to 6 hours.Answer
- DAdminister prescribed intermittent intravenous antibiotics through the same PICC lumen as the TPN infusion.
- EIncrease the infusion pump rate to catch up if the TPN volume infused falls behind the prescribed schedule.
Answer
The appropriate actions are replacing the TPN bag and tubing every 24 hours, keeping D10W available in case of sudden interruption, and monitoring blood glucose levels every 4 to 6 hours.
Appropriate management of TPN includes changing the bag and tubing every 24 hours to prevent bacterial growth in the lipid and dextrose-rich solution. Regular blood glucose monitoring is essential because the high glucose load can cause hyperglycemia. Additionally, keeping D10W available prevents rebound hypoglycemia if the TPN infusion must be stopped abruptly.
Step-by-Step Solution
Key Concept
Total Parenteral Nutrition (TPN) Administration Safety