Which scenario indicates total parenteral nutrition (TPN) is appropriate?

• A. Pt is able to meet needs PO, but has nonfunctioning GI tract
• B. Pt unable to meet needs PO, does not have functioning GI tract, has long-term needs (>7 days)
• C. Patient can meet needs PO with enteral support
• D. Po intake adequate with functioning GI tract.

Answer: (B)

When the gastrointestinal tract cannot be used to meet nutritional needs and support is needed for more than a short period, total parenteral nutrition is the appropriate approach. It delivers nutrients directly into the bloodstream, bypassing the gut. The scenario fits this: the patient cannot meet needs by mouth, there is no functioning GI tract, and long-term support (more than seven days) is anticipated. If the gut could be used or if oral/enteral feeding could meet the needs, TPN would not be chosen. In short, TPN is reserved for situations with gut nonfunction and prolonged nutritional requires, where oral or enteral routes are not feasible.