A nurse is assessing a client who has a prescription for cefaclor. Which of the following findings should the nurse recognize as an indication of an allergic reaction?

A) Discontinue the infusion: While discontinuing the parenteral nutrition infusion may be necessary in severe cases of hypoglycemia, it should not be the initial action unless the client's condition warrants it. Discontinuing the infusion without providing alternative sources of glucose may exacerbate the hypoglycemia and lead to further complications.

B) Obtain arterial blood gases: Arterial blood gases (ABGs) are not typically indicated for evaluating hypoglycemia. While ABGs provide valuable information about acid-base balance and oxygenation status, they do not directly assess blood glucose levels or contribute to the management of hypoglycemia.

C) Warm formula to room temperature: Warming the parenteral nutrition formula to room temperature may improve comfort during administration, but it is not directly related to managing hypoglycemia. Hypoglycemia requires prompt intervention to raise blood sugar levels, and warming the formula would not address the immediate need for glucose supplementation.

D) Administer IV dextrose: Hypoglycemia is a potentially serious complication of parenteral nutrition administration, especially if the infusion rate is too high or if the client's metabolic needs are not adequately met. IV dextrose, a concentrated glucose solution, is the most appropriate intervention for treating hypoglycemia in this situation. It provides a rapid source of glucose to raise blood sugar levels quickly and effectively.

A) Lactated Ringer's: Lactated Ringer's solution is not app’opriate in this si’uation because it does not provide the necessary nutrients found in TPN. It is primarily used for fluid replacement and maintenance and does not contain the essential macronutrients required for TPN.

B) Dextrose 10% in water: This is the correct fluid to administer when the current bag of TPN has finished infusing and the next bag is not yet available. Dextrose 10% in water provides a source of glucose, which can help prevent hypoglycemia in clients dependent on TPN. While it does not provide the full spectrum of nutrients found in TPN, it can temporarily meet the client's caloric needs until the next bag of TP’ becomes available.

C) 0.45% sodium chloride: This solution, also known as half-normal saline, is hypotonic and primarily used for hydration and maintenance fluids. It does not provide adequate nutrition and is not a suitable substitute for TPN.

D) 0.9% sodium chloride: This solution, also known as normal saline, is isotonic and used for fluid resuscitation, maintenance, and replacement. Like 0.45% sodium chloride, it does not contain the necessary nutrients for TPN and is not appropriate as a substitute.