In clients receiving total parenteral nutrition (TPN), which assessment is most important to monitor for a common complication?

• A. Decreased respiratory rate
• B. Blood glucose levels
• C. Urine output
• D. Serum potassium

Answer: (B)

The key idea is that TPN delivers a continuous, high glucose load, so the most common and important complication to catch early is elevated blood glucose. Regular glucose monitoring is essential because hyperglycemia from TPN can quickly lead to dehydration, electrolyte shifts, and increased infection risk, and it guides timely adjustments to the infusion rate or additions of insulin per protocol. In practice, blood glucose is checked frequently (often every 4–6 hours) and the TPN rate or insulin therapy is adjusted to maintain a safe range. While electrolyte disturbances and fluid balance are also important to track, they are secondary to preventing hyperglycemia, which can arise rapidly with TPN and drive other complications. If TPN is ever interrupted, watch for hypoglycemia and recheck glucose promptly when the infusion resumes.