A hospitalized client is receiving a continuous infusion of a maintenance fluid through a single-lumen peripheral venous catheter. The healthcare provider has prescribed a scheduled intravenous (IV) bolus medication that is physically incompatible with the current infusion. Arrange the following actions in the correct chronological order to safely deliver the medication.
- 1Stop the continuous intravenous infusion of the incompatible maintenance fluid.
- 2Flush the intravenous catheter with 10 mL of 0.9% sodium chloride.
- 3Administer the prescribed intravenous bolus medication over the recommended duration.
- 4Flush the catheter again with 10 mL of 0.9% sodium chloride at the same rate the medication was given.
- 5Restart the continuous maintenance fluid infusion at the prescribed rate.
Answer
The correct sequence for administering an incompatible IV bolus medication through a continuous infusion line is to first stop the continuous infusion, flush the line with normal saline, administer the medication, flush the line again with normal saline at the same rate the medication was given, and finally restart the continuous infusion.
When administering an IV bolus medication that is incompatible with a continuous infusion through the same line, the nurse must prevent the two fluids from mixing. This is achieved using the SAS (Saline-Administer-Saline) method. The nurse stops the continuous infusion and flushes the line with a compatible solution (like 0.9% sodium chloride) to clear the tubing. After administering the medication over the prescribed time, the nurse flushes the line again to clear the medication before restarting the incompatible continuous infusion. This prevents precipitation in the line and ensures safe drug delivery.
Step-by-Step Solution
Key Concept
Administration of an incompatible IV bolus medication via an existing continuous infusion line requires the Saline-Administer-Saline (SAS) technique to prevent drug precipitation and ensure patient safety.