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A patient is admitted with severe malnutrition. A central venous catheter is placed in the right subclavian vein and total parenteral nutrition (TPN) is started. What medical interventions may be initiated with the onset of hyperglycemia?

A.

Adding insulin to the TPN

B.

Discontinuing the infusion

C.

Weaning from the TPN over a 6-hour period

D.

Starting an infusion of 0.9% normal saline

Answer and Explanation

The Correct Answer is A

A. Insulin can be added to the TPN to control blood sugar levels. TPN often leads to hyperglycemia, and insulin is commonly added to the solution to regulate glucose levels.  
B. Discontinuing the infusion would not address the hyperglycemia and would risk nutrient deficiencies.  
C. Weaning from TPN may be indicated when discontinuing the nutrition support, but it is not a direct intervention for hyperglycemia.  
D. Starting an infusion of 0.9% normal saline would not address the hyperglycemia directly and may not be effective in managing the glucose levels.


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Related Questions

Correct Answer is D

Explanation

A. The head of the bed should be elevated to at least 30 degrees to reduce the risk of aspiration, not 45 degrees.
B. Enteral feeding is typically preferred over TPN because it preserves gut integrity and reduces the risk of complications such as infections.
C. Lipid intake should generally be monitored and controlled, but greater than 2 g/kg/day is not recommended and may lead to complications such as hyperlipidemia.
D. Excessive calorie intake, particularly from carbohydrates, can increase carbon dioxide production, leading to a rise in PaCO2 levels in mechanically ventilated patients.

Correct Answer is C

Explanation

A. Low levels of both HDL and LDL cholesterol is not desirable as low levels of HDL cholesterol are associated with a higher risk for heart disease.
B. Low levels of high-density lipoprotein (HDL cholesterol) are undesirable because HDL helps remove excess cholesterol from the bloodstream, and lower levels increase the risk of cardiovascular disease.
C. Low levels of low-density lipoprotein (LDL cholesterol) is the most desirable situation. Lower LDL levels reduce the risk of atherosclerosis and heart disease, making it important to lower these levels in patients with coronary artery disease.
D. Hypocholesterolemia (abnormally low cholesterol levels) is not typically targeted as a treatment goal and can be harmful in some situations, as cholesterol is essential for many bodily functions.

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