Evolve HESI Practice Exam

What should the nurse do immediately if the TPN solution runs out and the next solution is not available?

1. Administer nothing until the next TPN arrives

2. Infuse 5 percent dextrose and water

3. Infuse 10 percent dextrose and water at 54 ml/hr

4. Notify the healthcare provider immediately

The correct answer is: Infuse 10 percent dextrose and water at 54 ml/hr

Infusing 10 percent dextrose and water at the specified rate is the appropriate action to take if the TPN (total parenteral nutrition) solution runs out and the next solution is not immediately available. This protocol is crucial because TPN provides essential nutrients directly into the bloodstream, and abruptly stopping it can lead to severe metabolic abnormalities, including hypoglycemia. When TPN is suspended, the body's glucose levels can drop quickly due to the abrupt cessation of glucose delivery. Infusing a higher concentration of dextrose helps maintain blood glucose levels, preventing potential complications associated with low glucose levels. While 5 percent dextrose and water is also a possibility, a 10 percent solution is more appropriate since it more closely matches the energy supply typically provided by TPN. By infusing at 54 ml/hr, the infusion rate ensures a steady supply of glucose, which can help protect the patient from sudden drops in blood sugar levels until the TPN can be restarted. Maintaining stable glucose levels during this transition phase is essential for the patient’s ongoing metabolic support and overall safety.