مريض بعد عملية كبيرة في الأمعاء على تغذية وريدية كاملة (TPN) من يومين. اشتكى من عطش وكثرة تبول. السكر ٣١٢، وهو غير مصاب بالسكري سابقاً. العلامات الحيوية مستقرة. ما الإجراء الأنسب؟

A client on total parenteral nutrition for two days after major bowel surgery reports thirst and frequent urination. Glucose is 312 mg/dL; he is not known to be diabetic. Vitals are stable. What is the most appropriate action?

1. Notify the provider to adjust insulin or the solution and monitor glucose
2. Give oral juice to replace fluid lost in urine
3. Increase the infusion rate so he reaches the full prescribed dose quickly
4. Stop the TPN abruptly to avoid high glucose

Answer: A) Notify the provider to adjust insulin or the solution and monitor glucose. TPN is glucose-rich and can cause hyperglycaemia. Monitor glucose regularly and add insulin as ordered. Abrupt cessation risks rebound hypoglycaemia.