Surgery MCQ 181

A 60-year-old patient has been started on total parenteral nutrition (TPN) after a massive gut resection. The healthcare team monitors the patient closely for early complications associated with TPN.

What is the common early complication of TPN?

A. Fluid overload  
B. Tube blockage  
C. Infection  
D. Hypoglycemia  
E. Diarrhea  


Answer:

The Correct Answer is: A. Fluid overload

Explanation:

Fluid overload (A):

– Fluid overload is a common early complication of TPN, especially if the volume of fluid infused exceeds the patient’s requirements or if there is pre-existing cardiac or renal impairment.

– Careful monitoring of fluid balance, daily weights, and regular assessment of electrolyte levels are essential to prevent and manage this complication.

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Explanation of Incorrect Options:

Tube blockage (B):

– Tube blockage can occur but is not typically an early complication of TPN. It usually results from improper maintenance or infrequent flushing of the catheter.

Infection (C):

– Infection, particularly catheter-related bloodstream infection, is a serious complication of TPN but is more commonly a later complication due to prolonged catheter use. Strict aseptic technique is necessary to prevent this.

Hypoglycemia (D):

– Hypoglycemia is not a common early complication of TPN. More often, hyperglycemia is observed due to the high glucose content of TPN solutions, particularly in patients with impaired glucose metabolism.

Diarrhea (E):

– Diarrhea is not directly related to TPN since TPN bypasses the gastrointestinal tract entirely. Diarrhea may be a concern with enteral nutrition but not with parenteral nutrition.

In conclusion, fluid overload is the common early complication of TPN, making option A the correct answer.