A nurse is preparing to administer total parenteral nutrition (TPN) via a central venous catheter. Which clinical monitoring parameter is critical during TPN therapy due to the high dextrose concentration (typically 20% to 50%) of parenteral formulations?

Answer and explanation

Correct answer: D. Regular point-of-care blood glucose monitoring every 4 to 6 hours

  1. Step 1: TPN solutions contain high concentrations of hypertonic dextrose.
  2. Step 2: This exposes patients to severe hyperglycemia, which impairs immune function and induces osmotic diuresis and dehydration. Conversely, sudden TPN interruption can trigger severe rebound hypoglycemia; therefore, blood glucose must be monitored every 4-6 hours.
Answer
Regular point-of-care blood glucose monitoring every 4 to 6 hours.
Why not the others: 'Daily abdominal radiographs' are unnecessary radiation for parenteral nutrition; 'Twice-daily amylase and lipase' are only indicated if acute pancreatitis is suspected, not routine TPN monitoring; 'Continuous EEG' is irrelevant.

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