When a client's total parenteral nutrition (TPN) bag is empty, which action is appropriate for the nurse to take?

• A. Perform a finger stick glucose test and call the primary health care provider with the results.
• B. Hang a bag of 10% dextrose at the ordered TPN rate and place an urgent request for the next TPN bag.
• C. Discontinue the infusion and flush the intravenous (IV) line with saline solution until the next TPN bag is ready.
• D. Hang a bag of 5% dextrose at a keep-open rate and notify the nurse manager of the occurrence.

Answer: (B)

When a TPN bag runs dry, stopping the glucose delivery abruptly can cause dangerous hypoglycemia. To prevent that, you provide a glucose-containing solution to bridge the gap and keep blood glucose stable until the next TPN bag is available.

The best action is to hang a bag of dextrose 10% at the same rate as the prior TPN and arrange for the next TPN bag to be prepared urgently. This maintains continuous glucose delivery and minimizes risk, while you coordinate replacement.

Why the other options don’t fit: simply checking a finger-stick glucose and calling the provider doesn’t prevent a drop in glucose right away. Discontinuing the infusion and flushing with saline stops glucose delivery entirely and isn’t safe. Using a keep-open rate with 5% dextrose is inadequate to match the prior TPN’s glucose provision and could leave the patient under-fueled.