A nurse is providing care for a client who is receiving total parenteral nutrition (TPN) via a central venous access device. Which of the following nursing actions are necessary to ensure the safe administration of this therapy? Select all that apply.
- Monitor capillary blood glucose levels every 4 to 6 hours.Answer
- BIncrease the infusion rate to catch up if the volume falls behind the prescribed schedule.
- Replace the intravenous administration set and filter every 24 hours.Answer
- DAdminister scheduled intravenous push medications through the designated TPN port.
- Hang an infusion of 10% dextrose in water if the current TPN bag empties before a replacement is available.Answer
Answer
The correct actions include monitoring blood glucose every 4 to 6 hours, replacing the IV tubing and filter every 24 hours, and hanging 10% dextrose in water if the TPN bag runs out early.
Total parenteral nutrition requires meticulous nursing management to prevent metabolic and infectious complications. Because of the high dextrose content, routine capillary blood glucose checks (usually every 4 to 6 hours) are mandatory to monitor for hyperglycemia. If the TPN infusion is interrupted or runs dry before the pharmacy provides the next bag, the nurse must infuse 10% dextrose in water (D10W) at the prescribed TPN rate to prevent profound rebound hypoglycemia. Finally, due to the high risk of microbial growth in the nutrient-rich solution, the IV tubing and inline filter must be completely replaced every 24 hours.
Step-by-Step Solution
Key Concept
Total Parenteral Nutrition (TPN) Safety and Administration Principles