When transitioning or discontinuing TPN/PPN, which monitoring is essential?

• A. Monitor blood glucose; run D5 between solutions to prevent hypoglycemia
• B. Ignore glucose control
• C. Only monitor electrolytes
• D. Do not monitor with capillary glucose

Answer: (A)

When transitioning or discontinuing TPN/PPN, watching blood glucose is essential. TPN provides a constant infusion of glucose, and if it’s stopped abruptly, the remaining insulin in the body can drive a rapid drop in blood sugar, leading to hypoglycemia. To prevent this, you typically continue a dextrose-containing solution (such as D5) between changes or as you taper off, ensuring a gradual and controlled supply of glucose. Frequent capillary glucose checks help detect hypoglycemia early so you can treat it promptly. Monitoring electrolytes alone or ignoring glucose control won’t catch or prevent this risk during the transition.