Total Parenteral Nutrition – RN Management

Total parenteral nutrition (TPN) delivers complete nutritional requirements intravenously when the GI tract is non-functional. It is an advanced nursing skill requiring precise monitoring and rigorous infection prevention. NCLEX-RN (Canadian NCLEX-RN) tests: central line management, glucose monitoring, refeeding syndrome recognition, and what can and cannot be administered through a TPN line. Indications for TPN: Prolonged NPO (>5–7 days expected), short bowel syndrome, severe malabsorption, GI fistula, severe pancreatitis, bowel obstruction, post-surgical ileus, critically ill patients unable to tolerate enteral feeding. TPN vs. Enteral Nutrition: Enteral nutrition is always preferred when the GI tract is functional. TPN is used ONLY when the gut cannot be used. The GI tract needs stimulation to maintain mucosal integrity — TPN bypasses this. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar. Run a 60-second scan: breathing work and oxygenation, perfusion and end organs, neuro baseline, likely infection sources, and devices that can fail...