How should you discontinue TPN?

• A. Gradually reduce before disconnecting to avoid hypoglycemia
• B. Immediately disconnect without tapering
• C. Stop abruptly without monitoring
• D. Switch to saline parenteral solution

Answer: (A)

Discontinuing TPN safely hinges on tapering the infusion rather than stopping abruptly. The body has adapted to a continuous glucose delivery from TPN, along with insulin response to that glucose. If you disconnect suddenly, circulating insulin can continue to drive glucose into tissues, risking significant hypoglycemia. By gradually reducing the TPN rate before stopping, you give the body time to adjust—insulin levels fall and the liver can gradually take over maintaining blood glucose through endogenous glucose production. Throughout the taper, monitor blood glucose and have a plan to provide calories through oral or enteral feeding or a lower-rate IV source if needed, so the transition remains smooth and stable.

Switching abruptly to saline or disconnecting without tapering deprives the patient of calories too quickly and can precipitate hypoglycemia or metabolic instability, and stopping without monitoring misses early signs of trouble.