Question

A nurse is caring for a client who is receiving total parenteral nutrition (TPN). the current bag of TPN is empty and a new bag is not available on the unit. which of the following solutions should the nurse infuse until a new bag of TPN is available?

A) Dextrose 10% in water
B) 0.45% sodium chloride
C) Dextrose 5% in lactated Ringer's
D) 0.9% sodium chloride

Answer 1

When a TPN bag is empty and a new one is not available, the nurse should infuse Dextrose 10% in water (D10W) as an interim solution to maintain blood glucose levels and prevent hypoglycemia.

Step-by-step explanation:

A nurse who finds that the current bag of TPN (Total Parenteral Nutrition) is empty and a new bag is not immediately available should opt for an alternative intravenous (IV) solution that closely mimics the osmolarity of TPN to prevent osmotic shifts and complications. Ideally, a dextrose 10% in water (D10W) should be infused until the new TPN bag is available. This solution provides a concentrated source of glucose to maintain the patient's blood glucose levels and prevent hypoglycemia, which can occur if TPN is suddenly stopped.

Other solutions like 0.45% sodium chloride, dextrose 5% in lactated Ringer's, or 0.9% sodium chloride are not as ideal. A 0.45% sodium chloride is a hypotonic solution and may not provide adequate glucose, dextrose 5% in lactated Ringer's includes electrolytes that may not be necessary, and 0.9% sodium chloride (normal saline) is isotonic but does not provide the necessary glucose support. TPN solutions are high in glucose content, which necessitates a higher glucose content in the interim solution such as D10W.