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Difficulty: HardAccident, Error, and Injury Prevention

A nurse is caring for a postoperative client who has a continuous epidural infusion for analgesia, a peripheral intravenous (IV) catheter, and an enteral feeding tube. The nurse is preparing to administer a prescribed IV push antibiotic. To prevent a catastrophic tubing misconnection error, which action is the most critical for the nurse to perform?

  1. A
    Instruct the unlicensed assistive personnel to place identifying labels on all tubes and catheters prior to the medication administration.
  2. B
    Prioritize rapid administration by injecting the medication into the nearest port that is not currently connected to an electronic infusion pump.
  3. Physically trace the tubing from the peripheral IV catheter insertion site on the client's body up to the intended injection port.Answer
  4. D
    Verify the antibiotic's compatibility with the epidural analgesic solution to prevent precipitation if the wrong line is accidentally used.

Answer

The nurse must physically trace the tubing starting from the client's peripheral IV insertion site up to the injection port before administering the medication.
Tubing misconnections are a critical, often fatal, medical error. To prevent administering an intravenous medication into an epidural or enteral line, the evidence-based safety standard is to physically trace the tubing starting directly from the patient's insertion site (the peripheral IV) up to the port where the medication will be injected. Relying on memory, labels, or the presence of an infusion pump is insufficient and dangerous.

Step-by-Step Solution

1
Identify all access lines currently attached to the client.
The client has multiple distinct access routes: an epidural, an enteral tube, and a peripheral IV.
Recognizing the presence of multiple lines highlights a high risk for potentially fatal tubing misconnections.
2
Select the correct physiological route for the prescribed medication.
The antibiotic is prescribed via the intravenous route.
Administering an intravenous medication via an epidural or enteral route can lead to severe neurotoxicity, paralysis, or death.
3
Verify the correct line through physical tracing.
The nurse traces the tubing from the peripheral IV site on the client's body directly up to the injection port.
Tracing from the patient to the port is the only evidence-based standard to ensure the medication enters the correct vascular system.

Key Concept

Prevention of Tubing Misconnections
Estimated Time:1m 30s
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Topics

Accident, Error, and Injury Prevention

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