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    Nurs 547 Med Surg Proctored Exam(Examplify)

    The nurse notes that a patient's TPN (total parenteral nutrition) infusion is complete and a new bag is not available. Which action by the nurse is most appropriate?

    Explanation & Rationale

    A. Hang a bag of D10W to infuse at the TPN rate: Abruptly stopping TPN can cause hypoglycemia because the patient has been receiving continuous high-concentration glucose. Administering a dextrose 10% solution at the same rate as the TPN provides a continuous glucose supply, maintaining blood glucose levels until the next TPN bag is available. B. Check the patient's blood sugar and administer D50W as needed: While monitoring blood glucose is important, giving intermittent D50W boluses does not provide a steady glucose supply and may cause rapid fluctuations in blood sugar, increasing the risk of rebound hypoglycemia or hyperglycemia. C. Call the provider to validate the order for the TPN: Contacting the provider for clarification may be appropriate for future planning, but it does not address the immediate risk of hypoglycemia if TPN is abruptly stopped, making this action insufficient as the primary intervention. D. Flush the intravenous catheter line and wait for the next bag to arrive: Waiting without providing an alternative glucose source can result in dangerous hypoglycemia. Flushing the line alone does not maintain metabolic stability, which is essential for patients on continuous TPN.

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