One is not the indication of total parenteral nutrition –
**Core Concept**
Total parenteral nutrition (TPN) is a method of providing essential nutrients to patients who cannot receive feedings or fluids by mouth. It involves the administration of a mixture of nutrients, including carbohydrates, proteins, and fats, through a vein. TPN is typically used in patients with short bowel syndrome, severe burns, or those who have had surgical resection of the gut.
**Why the Correct Answer is Right**
The correct answer is because TPN is not indicated in cases of **absolute contraindications**, one of which is **peritonitis**. Peritonitis is an inflammatory condition of the peritoneum, the lining of the abdominal cavity, often caused by bacterial infection. Administering TPN in this scenario can lead to further complications, such as **infection** and **abscess formation**.
**Why Each Wrong Option is Incorrect**
* **Option A:** While **gastrointestinal obstruction** may require TPN, it is not a contraindication.
* **Option B:** **Diabetes mellitus** is not a contraindication to TPN, as it can be managed with insulin.
* **Option C:** **Hepatic failure** may require TPN, as it can be used to provide essential nutrients to the liver.
**Clinical Pearl / High-Yield Fact**
It's essential to note that TPN should be administered under the guidance of a multidisciplinary team, including a dietitian, pharmacist, and clinician.
**Correct Answer:** D.