AIIMS Rishikesh & Jod…: A nurse caring a patient which receiving TPN in ICU, what is the right intervention of the nurse? & x20;

AIIMS Rishikesh & Jodhpur NO - 2017

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

to discard the TPN bag after 24 hours, even if fluid remains.
TPN solutions have a high concentration of glucose and lipids, which creates an ideal medium for bacterial and fungal growth.
Changing the bag and tubing every 24 hours is a strict infection control protocol to prevent Central Line-Associated Bloodstream Infections (CLABSI), a serious and potentially fatal complication.
This practice is a standard of care in nursing to ensure patient safety during parenteral nutrition therapy.

Option B: This option is too vague. While the general goal is to continue the therapy, it does not describe a specific, critical nursing intervention required for safe TPN administration.
Option C: Stopping TPN abruptly is dangerous and contraindicated. It can lead to severe rebound hypoglycemia.
Option D: This option is incorrect because options B and C are incorrect. Option C describes a harmful action.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Safe Administration of Total Parenteral Nutrition (TPN) in acute care settings.
A nurse's adherence to the 24-hour TPN bag and tubing change protocol is a primary defense against life-threatening Central Line-Associated Bloodstream Infections (CLABSI).
Failure to follow this protocol can be considered a breach of the standard of care and significantly increases patient morbidity and mortality.
What if? If a TPN bag runs empty two hours before the next scheduled bag is available from the pharmacy, the nurse's priority action is to hang a 10% Dextrose in Water (D10W) solution at the same infusion rate to prevent rebound hypoglycemia until the new TPN bag arrives.

How to Approach the Question

First, identify the core clinical topic of the question, which is the administration of Total Parenteral Nutrition (TPN).
Recognize that TPN is a high-risk therapy requiring strict adherence to safety protocols.
Evaluate each option based on two key principles of TPN management: infection control and metabolic stability.
Analyze Option A: Discarding the bag at 24 hours directly relates to the critical infection control principle due to the high glucose content of TPN.
Analyze Option C: Stopping TPN relates to metabolic stability. Recall that abrupt cessation is dangerous and causes rebound hypoglycemia.
Based on this analysis, identify Option A as a mandatory safety action and Option C as a dangerous, incorrect action. This allows you to eliminate C and D, and confirms A as the best answer.

Concept Tested & Keywords

Concept Tested: Safe Administration of Total Parenteral Nutrition (TPN)
Stem keywords: TPN, ICU, nurse, intervention
Lead-in keywords: right intervention
Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.
Negative lead-in flag: false

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