Care Manager Certification Practice Exam

What should the nurse monitor for if the total parenteral nutrition (TPN) solution is not infusing?

1. Excessive thirst and urination

2. Shakiness and diaphoresis

3. Fever and chills

4. Hypertension and crackles

The correct answer is: Shakiness and diaphoresis

The correct choice of monitoring for shakiness and diaphoresis is important because these symptoms can indicate hypoglycemia, a potential complication that arises when total parenteral nutrition (TPN) is not infusing. TPN provides essential nutrients, including carbohydrates in the form of dextrose. If the infusion stops, the patient may not receive the necessary glucose, leading to a drop in blood sugar levels. Hypoglycemia can present with symptoms such as shakiness, diaphoresis (sweating), confusion, and in severe cases, seizures or loss of consciousness. Monitoring for this convergence of symptoms helps ensure timely intervention, such as administering glucose, to mitigate the effects of hypoglycemia and prevent further complications. In contrast, the other options relate to different complications or conditions that may not be directly associated with the lack of TPN infusion. For example, excessive thirst and urination could suggest diabetes mellitus or dehydration, fever and chills might indicate an infection, and hypertension and crackles could point to fluid overload or heart failure, which are not the primary focus when considering the immediate effects of halted TPN. Recognizing the signs of hypoglycemia from interrupted TPN is vital for patient safety and effective care management.