A client is being weaned off from parenteral nutrition (PN) and is given a go-signal to take a regular diet. The ongoing solution rate has been 120ml/hr. A nurse expects that which of following prescriptions regarding PN solution will accompany diet order?

Correct Answer: A. Decrease the PN rate to 60ml/hr.

When a client begins eating a regular diet after a period of receiving PN, the PN is decreased slowly. Gradually decreasing the infusion rate allows the client to remain sufficiently nourished during the transition to a normal diet and prevents an episode of hypoglycemia.

• Option B: Parenteral nutrition is the intravenous administration of nutrition outside of the gastrointestinal tract. Total parenteral nutrition (TPN) is when the IV administered nutrition is the only source of nutrition the patient is receiving. Total parenteral nutrition is indicated when there is an inadequate gastrointestinal function and contraindications to enteral nutrition.
• Option C: Patients who recently received TPN should be monitored daily until stable. They require more frequent monitoring if metabolic abnormalities are detected or if the patient has a risk of refeeding syndrome. Refeeding syndrome can occur in severely malnourished and cachectic individuals when feeding is reintroduced and can lead to severe electrolyte instabilities.
• Option D: PN that is terminated abruptly will cause hypoglycemia. Total parenteral nutrition administration is through a central venous catheter. A central venous catheter is an access device that terminates in the superior vena cava or the right atrium and is used to administer nutrition, medication, chemotherapy, etc. Establishing this access could be through a peripherally inserted central catheter (PICC), central venous catheter, or an implanted port.