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Difficulty: MediumPharmacological and Parenteral Therapies

A nurse is caring for an adult client who is post-operative day one following a right total hip arthroplasty. The client is receiving a continuous intravenous (IV) infusion of 0.9%0.9\% sodium chloride. The provider has prescribed several new oral and intravenous medications. Which of the following nursing actions demonstrate safe pharmacological and parenteral therapy practices? Select all that apply.

  1. Stopping the primary continuous infusion and flushing the line with normal saline before and after administering an incompatible secondary antibiotic.Answer
  2. Scrubbing the needleless connector hub with an approved antiseptic swab with friction prior to attaching a medication syringe.Answer
  3. C
    Assisting the client into a high-Fowler's position with hips flexed past 9090 degrees to facilitate safe swallowing of oral pain medications.
  4. D
    Connecting a secondary piggyback infusion to the primary line without checking compatibility, assuming most medications mix safely with normal saline.
  5. E
    Calculating a weight-based medication dosage by multiplying the client's weight in pounds by 2.22.2 to determine the weight in kilograms.
  6. Verifying the client's identity using two acceptable identifiers and scanning the medication barcode prior to administration.Answer

Answer

The correct actions are stopping the primary infusion and flushing before and after incompatible antibiotics, scrubbing the needleless hub prior to access, and verifying client identity with two identifiers alongside barcode scanning.
Safe pharmacological administration requires strict adherence to infection control (scrubbing the hub), the rights of medication administration (using two patient identifiers and scanning barcodes), and proper intravenous line management (flushing lines before and after incompatible medications to prevent precipitation).

Step-by-Step Solution

1
Evaluate the medication administration steps for adherence to the rights of medication administration and infection control.
Identifying the patient with two identifiers and scrubbing the hub with friction are standard, mandatory safety protocols.
These actions prevent critical medication errors and healthcare-associated infections.
2
Analyze the management of intravenous lines when multiple medications are involved.
Administering incompatible medications requires stopping the primary infusion and flushing the line thoroughly between medications. Compatibility must always be checked.
Mixing incompatible medications can cause crystallization or precipitation in the IV line, leading to catheter occlusion or systemic emboli.
3
Assess the clinical context (total hip arthroplasty) and mathematical principles for safe administration.
Positioning the client with hips flexed past 90 degrees violates post-operative hip precautions. Converting pounds to kilograms requires division, not multiplication.
Flexing the hip past 90 degrees can dislocate the new prosthesis. Multiplying pounds by 2.2 leads to a dangerous medication overdose.

Key Concept

Safe Pharmacological and Parenteral Therapies
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Topics

Pharmacological and Parenteral Therapies

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