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Difficulty: EasyPharmacological and Parenteral Therapies

A clinical educator is evaluating a nursing student preparing to administer an intermittent intravenous (IV) antibiotic infusion into a patient's dedicated primary continuous IV line. Which actions by the student demonstrate correct application of parenteral therapy safety principles? Select all that apply.

  1. Cleansing the designated needleless connector on the primary tubing with an approved antiseptic wipe before attachment.Answer
  2. Confirming the physical and chemical compatibility of the prescribed antibiotic with the primary fluid prior to administration.Answer
  3. Suspending the secondary medication bag on the intravenous pole at a level higher than the primary fluid container.Answer
  4. D
    Proceeding with the secondary infusion through the same lumen despite knowing it is chemically incompatible with the primary fluid.
  5. E
    Instructing the unlicensed assistive personnel (UAP) to perform the initial patency check of the intravenous insertion site.
  6. F
    Programming the infusion pump rate based on a quick mental estimate without verifying the exact ordered dosage calculation.

Answer

The correct actions include cleansing the needleless connector before attachment, confirming fluid compatibility, and suspending the secondary bag higher than the primary fluid.
Safe parenteral therapy requires strict adherence to infection control (cleansing the connector), verification of chemical compatibility to prevent precipitation, and proper equipment setup (hanging the secondary bag higher to utilize gravity). These actions ensure the medication is delivered safely and effectively without compromising the patient's vascular access.

Step-by-Step Solution

1
Evaluate the requirement for infection control during IV administration.
Identify that scrubbing the needleless connector is essential to prevent central line-associated or peripheral bloodstream infections.
Maintaining aseptic technique is a fundamental safety principle in parenteral therapy.
2
Assess the principles of drug compatibility.
Determine that the nurse must verify the antibiotic is compatible with the continuous IV fluid.
Mixing incompatible solutions can cause dangerous precipitation in the IV line.
3
Analyze the mechanical setup of a secondary IV infusion.
Recognize that the secondary (piggyback) bag must be hung higher than the primary bag.
Gravity allows the higher bag to exert more hydrostatic pressure, infusing first.
4
Review the distractors for safety and delegation violations.
Eliminate options that involve infusing incompatible fluids, delegating initial assessments to UAP, or estimating pump rates.
These actions directly violate the nursing scope of practice and medication safety protocols.

Key Concept

Safe Parenteral Medication Administration Principles
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Topics

Pharmacological and Parenteral Therapies

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