A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following client findings should the nurse identify as an adverse effect of TPN administration?

A. Hyperglycemia: TPN contains high concentrations of glucose, which can lead to elevated blood sugar levels. Clients receiving TPN should have frequent blood glucose monitoring, and insulin may be required to manage hyperglycemia. B. Hyperkalemia: While electrolyte imbalances can occur with TPN, potassium is typically added in controlled amounts to the solution. Hyperkalemia is not a common direct adverse effect unless the formulation is incorrect or the client has impaired renal function. C. Hypermagnesemia: Magnesium levels in TPN are carefully regulated, and hypermagnesemia is uncommon. Over-supplementation could cause this, but it is not a typical adverse effect for most clients receiving standard TPN. D. Urine output of 160 mL in 4 hr: This urine output falls within normal limits (approximately 0.5 mL/kg/hr). Oliguria or significantly reduced urine output would be concerning, but 160 mL in 4 hours does not indicate an adverse effect of TPN.