A critically ill client with distributive shock is being supported by a continuous norepinephrine infusion via a dedicated single-lumen central venous catheter. While the nurse is performing an assessment, the client abruptly exhibits generalized tonic-clonic seizure activity. An emergency prescription for immediate intravenous lorazepam is received. Which action by the nurse represents the safest practice for administering this medication?
- AInject the prescribed medication directly into the most proximal Y-site on the continuous vasopressor tubing.
- BPause the continuous vasopressor, flush the line with sterile saline, push the prescribed medication, and restart the pump.
- Obtain a new peripheral intravenous access to administer the prescribed medication.Answer
- DAdminister the medication as a secondary intermittent infusion over to prevent vascular irritation.
Answer
The correct action is to establish a new peripheral intravenous access to administer the lorazepam, ensuring the continuous vasopressor infusion remains uninterrupted.
Using a separate, new vascular access ensures that the life-sustaining vasopressor infusion remains continuous and uninterrupted. This prevents an accidental bolus of the vasopressor, which could trigger a catastrophic hypertensive crisis or fatal dysrhythmia.
Step-by-Step Solution
Key Concept
Vasoactive medications require a dedicated intravenous line; flushing the line or pushing medications through it can cause life-threatening hemodynamic instability.