A nurse is preparing to discontinue long-term total parenteral nutrition (TPN) therapy for a client. The nurse should gradually to reduce the risk of which of the following adverse effects?

Rationale: A. Hyperglycemia: Hyperglycemia is more likely to occur when initiating TPN or if the infusion rate is increased too rapidly, due to the high glucose concentration in the solution. Gradually discontinuing TPN does not typically cause elevated blood glucose levels, as exogenous glucose intake is being reduced rather than increased. B. Hypoglycemia: Abrupt discontinuation of long-term TPN can lead to hypoglycemia because the client’s pancreatic insulin secretion and glycogen stores are adapted to a continuous high-glucose infusion. Gradual tapering allows the body to adjust metabolically while maintaining adequate blood glucose levels. Supplemental oral or enteral nutrition may be introduced concurrently to prevent sudden drops in serum glucose. C. Diarrhea: Diarrhea is more commonly associated with rapid infusion of hyperosmolar solutions or changes in enteral feeding, not TPN discontinuation. Gradual reduction of TPN itself does not directly cause increased stool frequency, although electrolyte imbalances can contribute if improperly managed. D. Constipation: Constipation is not a typical complication of discontinuing TPN, as TPN bypasses the gastrointestinal tract entirely. Gastrointestinal motility may temporarily adjust when transitioning to enteral or oral feeding, but tapering TPN is primarily aimed at preventing hypoglycemia rather than affecting bowel movements.