A nurse is monitoring a client on continuous TPN. Which set … | MyMerci
Medical EmergenciesPA
Question
A nurse is monitoring a client on continuous TPN. Which set of monitoring practices is essential?
1Daily intake only
2No glucose monitoring needed
3Weekly vitals only
4Bedside glucose every 6 hours initially; daily weights, I/O, electrolytes including phosphate/Mg/Ca; LFT and triglycerides periodically; CVAD site every shift✓ Correct answer
Explanation
Correct (2): TPN monitoring includes bedside glucose q6h initially (hyperglycemia is common), daily weights, strict I/O, daily electrolytes (BMP + Mg, P, Ca), periodic LFT/triglycerides, and CVAD insertion site assessment every shift. Insulin may be added directly to the TPN bag per protocol. (1,3,4) Inadequate.
In-depth explanation
Memory Tip TPN monitoring = "Glucose·Weight·I/O·Lytes·LFT·TG·Site." Hyperglycemia → sliding scale or insulin in bag. Hypoglycemia if TPN stopped abruptly.
Clinical scenario
Scenario Adult on continuous central TPN day 4; ICU setting.
Key concepts
TPN glucose monitoring — Bedside glucose every 4-6 hours initially; insulin added to bag if needed.