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Difficulty: EasyPharmacological and Parenteral Therapies

A nurse is preparing to administer an intravenous (IV) antibiotic piggyback to a client receiving a compatible continuous primary infusion of 0.9% sodium chloride. Place the following steps for setting up the secondary infusion in the correct chronological order.

  1. 1Close the roller clamp on the secondary IV tubing.
  2. 2Spike the secondary medication bag and prime the tubing.
  3. 3Scrub the uppermost access port of the primary tubing with an antiseptic swab.
  4. 4Connect the primed secondary IV tubing to the cleansed primary line port.
  5. 5Hang the primary IV fluid bag lower than the secondary medication bag.

Answer

The correct chronological sequence is to close the secondary roller clamp, spike and prime the secondary line, cleanse the primary access port, connect the lines, and hang the primary bag lower than the secondary bag.
Following the proper chronological sequence for an IV piggyback setup ensures patient safety by preventing fluid loss, avoiding air embolisms, maintaining strict asepsis, and utilizing gravity correctly for the secondary infusion.

Step-by-Step Solution

1
Close the roller clamp on the secondary IV tubing.
The tubing is sealed.
Prevents medication from freely running out of the tubing when the bag is spiked.
2
Spike the secondary medication bag and prime the tubing.
The line is filled with fluid and devoid of air.
Removes atmospheric air from the line to prevent an air embolism.
3
Scrub the uppermost access port of the primary tubing with an antiseptic swab.
The access port is disinfected.
Maintains strict aseptic technique to prevent catheter-related bloodstream infections.
4
Connect the primed secondary IV tubing to the cleansed primary line port.
The secondary line is integrated into the primary infusion system.
Establishes a continuous, secure pathway for the medication to reach the patient.
5
Hang the primary IV fluid bag lower than the secondary medication bag.
The secondary bag has greater hydrostatic pressure.
Utilizes gravity so the pump draws fluid from the highest bag (the medication) until it is empty.

Key Concept

Intravenous Piggyback (IVPB) Setup Sequence
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Topics

Pharmacological and Parenteral Therapies

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