medium · NCLEX-RN Pharmacological and Parenteral Therapies

During the third day of TPN therapy, a client's capillary glucose is 242 mg/dL. The client has no history of diabetes.

What is the most likely pathophysiologic mechanism for this finding?

  1. Abrupt cessation of the infusion has triggered rebound glycogenolysis.
  2. The TPN bag was infused too slowly, causing a compensatory hepatic glucose release.
  3. The high-dextrose load of the PN exceeds the client's current endogenous insulin capacity.
  4. The client is experiencing the Somogyi effect due to overnight infusion, for this client.

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