A client is receiving a continuous intravenous (IV) infusion of heparin for the treatment of a pulmonary embolism. The client has a single peripheral IV catheter. The healthcare provider prescribes a scheduled dose of IV piggyback levofloxacin. Upon checking a drug reference guide, the nurse determines that levofloxacin is physically incompatible with heparin. What is the most appropriate action by the nurse?
- Insert a second peripheral IV catheter to administer the levofloxacin.Answer
- BStop the heparin infusion, flush the line with 0.9% sodium chloride, infuse the levofloxacin, flush again, and restart the heparin.
- CAttach the levofloxacin tubing to the highest Y-site port on the primary IV tubing to allow the medications to dilute.
- DAdminister the levofloxacin concurrently through the existing line at a slower rate to prevent precipitation.
Answer
The most appropriate action is to insert a second peripheral IV catheter to administer the levofloxacin.
Establishing a new intravenous line is the only action that prioritizes patient safety by maintaining the continuous therapeutic level of heparin while simultaneously ensuring the timely administration of the antibiotic. Because the two medications are chemically incompatible, they cannot share a line, and because heparin has a very short half-life, it cannot be safely paused.
Step-by-Step Solution
Key Concept
Continuous infusions of critical medications with short half-lives (like heparin or vasoactive drips) should not be interrupted to administer incompatible secondary infusions. A separate IV access must be established.