After the remaining TPN has infused, which action should the nurse take to prevent hypoglycemia?

• A. Apply a lock and flush the line with a heparin sodium flush solution
• B. Hang a 500 mL bag of normal saline at a KVO rate
• C. Hang a liter of 10% dextrose in water at the same rate of infusion
• D. Hang a liter of Lactated Ringer's solution at the same rate of infusion

Answer: (C)

The key idea is preventing rebound hypoglycemia by ensuring a continuous glucose source during the transition off TPN. When TPN finishes, the glucose supply suddenly drops while insulin levels may still be elevated, which can quickly lead to low blood sugar. Providing a dextrose-containing IV solution at the same rate as the TPN preserves circulating glucose and gives the body time to adjust or for nutrition to be resumed safely. A liter of 10% dextrose in water delivers glucose steadily, bridging the gap until dextrose can be reduced or another nutrition plan is established. The other fluids—no-glucose solutions like normal saline or lactated ringers, or line patency maneuvers—do not supply glucose and won’t prevent hypoglycemia. Monitor blood glucose during this bridging period and adjust as needed.