Which finding would most strongly indicate hyperglycemia in a client receiving total parenteral nutrition?

• A. Paralytic ileus
• B. Serum glucose of 105 mg/dL (5.8 mmol/L)
• C. Polyuria
• D. Respiratory rate of 26 breaths/min

Answer: (C)

Polyuria would be the strongest sign. When glucose levels are high, the kidneys can’t reabsorb all of it, so glucose spills into the urine and pulls water with it—osmotic diuresis. In someone on total parenteral nutrition, this frequent urination is a clear and direct response to excess glucose infusion. The other findings don’t specifically point to high glucose: paralytic ileus is a GI motility issue, a serum glucose of 105 mg/dL is normal, and a faster breathing rate can result from many different problems, not the glucose level itself.