A patient has been on total parenteral nutrition (TPN) for 3 weeks after an episode of severe gastrointestinal bleeding. The physician plans to discontinue TPN. What order should the nurse anticipate?
a. Start tube feedings TID via nasogastric tube.
b. Place the patient on clear liquids for 1 week.
c. Taper TPN rate and introduce regular feedings slowly.
d. Sodium-restricted diet with high-protein snacks bid.
ANS: C
When TPN therapy is begun, the rate is increased gradually to the prescribed rate to help prevent hyperglycemia. When it ends, the rate is gradually decreased to prevent hypoglycemia. Tube feedings use the gastrointestinal system the same as oral feedings; clear liquids do not provide enough protein; and a sodium-restricted diet or high-protein snacks are not indicated.
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