During TPN administration for a malnourished client, a blood glucose reading of 425 mg/dL is noted. What action should the nurse take?

In the scenario presented, a blood glucose reading of 425 mg/dL during TPN (Total Parenteral Nutrition) administration indicates hyperglycemia, which can be a potentially serious complication of TPN therapy. When hyperglycemia is identified, it is essential for the healthcare team to evaluate the situation and determine appropriate interventions.

Notifying the physician is a critical step because elevated blood glucose levels may require medical intervention, such as adjustments to the TPN formula or the addition of insulin to manage the patient's blood glucose. The physician will be able to assess the severity of the hyperglycemic state, investigate its potential causes—such as the composition of TPN or patient-specific factors—and prescribe appropriate treatment measures, including the administration of insulin, if necessary.

Taking immediate action by notifying the physician ensures that the client receives timely and medically appropriate interventions to prevent further complications, such as diabetic ketoacidosis or osmotic diuresis. It is vital to maintain effective communication within the healthcare team to manage the patient’s condition appropriately.

In this context, while administering insulin or adjusting the TPN flow rate could be relevant interventions for managing hyperglycemia, those actions require a physician's order based on the overall assessment of the patient’s status.