An electronic infusion pump is delivering a continuous infusion of 0.9% sodium chloride to a client. The healthcare provider prescribes a scheduled dose of an antibiotic to be given via intermittent intravenous piggyback (IVPB). The two solutions are compatible. Arrange the following nursing actions in the correct sequence to initiate this therapy.
- 1Perform hand hygiene and verify the antibiotic against the medication administration record.
- 2Spike the intravenous piggyback bag and prime the secondary tubing to remove air.
- 3Scrub the primary tubing access port located above the infusion pump with an antiseptic swab.
- 4Attach the primed secondary tubing to the cleansed port on the primary line.
- 5Suspend the primary intravenous fluid bag lower than the piggyback bag using an extension hook.
- 6Open the secondary roller clamp, set the prescribed rate on the infusion pump, and start the infusion.
Answer
The correct sequence is: First, perform hand hygiene and verify the antibiotic against the MAR. Second, spike the piggyback bag and prime the secondary tubing. Third, scrub the primary tubing access port located above the pump. Fourth, attach the primed secondary tubing to the cleansed port. Fifth, suspend the primary fluid bag lower than the piggyback bag using a hook. Finally, open the clamp and set the rate on the pump.
The correct sequence ensures patient safety, asepsis, and proper functioning of the electronic infusion pump. Verifying the medication and performing hand hygiene are standard initial steps. Preparing and priming the secondary tubing removes dangerous air from the system. Scrubbing the port ensures asepsis. The secondary tubing must strictly be attached to a port above the infusion pump so the machine can control the flow rate. Finally, the primary continuous bag must be lowered using an extension hook so that hydrostatic pressure allows the higher secondary medication to infuse first.
Step-by-Step Solution
Key Concept
Intravenous Piggyback (IVPB) Administration Sequence