A client is receiving total parenteral nutrition (TPN) through a single-lumen peripherally inserted central catheter (PICC). The healthcare provider prescribes a scheduled dose of intravenous (IV) ciprofloxacin to treat a systemic infection. Which of the following actions is the most appropriate for the nurse to take?
- Insert a new peripheral venous catheter to administer the prescribed antibiotic.Answer
- BAttach the antibiotic tubing to the Y-site port closest to the central catheter insertion site.
- CSuspend the parenteral nutrition temporarily, flush the line with normal saline, give the antibiotic, and resume the nutrition.
- DIncrease the infusion rate of the parenteral nutrition to finish the current volume before the antibiotic is due.
Answer
The most appropriate action is to establish a separate, new peripheral venous access device to administer the antibiotic, as the single-lumen PICC must remain dedicated solely to the total parenteral nutrition.
Total parenteral nutrition (TPN) solutions are complex formulations with a very high risk for physical and chemical incompatibilities when combined with other drugs. Additionally, because of its high dextrose and lipid content, accessing the line frequently heavily increases the risk of a central line-associated bloodstream infection. Therefore, evidence-based best practice dictates that a single-lumen catheter used for TPN must remain exclusively dedicated to the nutrition infusion. The nurse must establish a separate peripheral venous access site to administer the intravenous antibiotic safely.
Step-by-Step Solution
Key Concept
Total Parenteral Nutrition (TPN) Administration Safety and Dedicated Vascular Access