A nurse is preparing to administer furosemide 40 \text{ mg} via intravenous (IV) push thro… — NCLEX-RN

A nurse is preparing to administer furosemide $40 \text{ mg}$ via intravenous (IV) push through a peripheral saline lock to a client with an exacerbation of heart failure. To prevent ototoxicity, institutional guidelines require administering the medication slowly over at least $2 \text{ minutes}$ . Which action demonstrates the safest and most appropriate administration technique?

A
Dilute the furosemide with $10 \text{ mL}$ of normal saline in the syringe and administer the entire mixed volume steadily over $1 \text{ minute}$ .
B
Push the furosemide over $2 \text{ minutes}$ , followed immediately by a rapid flush of $5 \text{ mL}$ of normal saline to clear the line and maintain patency.
Administer the furosemide over $2 \text{ minutes}$ , then flush the IV extension tubing with normal saline over an additional $2 \text{ minutes}$ .Answer
D
Flush the line with normal saline, push the furosemide over $2 \text{ minutes}$ , and omit the post-administration flush to prevent unnecessary fluid volume overload.

Answer

The nurse must administer the furosemide over

2 \text{ minutes}

and then flush the saline lock with normal saline at the same slow rate (over an additional

2 \text{ minutes}

The correct action accounts for the physical dead space inside the IV extension tubing. When the medication syringe is empty, a portion of the furosemide remains trapped inside the tubing. If the nurse subsequently flushes the line rapidly, that residual medication is delivered to the client as an instant, rapid bolus, which dramatically increases the risk of ototoxicity. Therefore, the saline flush must also be administered slowly over the same duration as the primary medication.

Step-by-Step Solution

Identify the risk associated with rapid administration of IV furosemide.

Rapid IV push of furosemide can cause ototoxicity, so the dose must be given slowly over at least

2 \text{ minutes}

Patient safety and adherence to pharmacological administration guidelines.

Analyze the mechanics of a peripheral saline lock and extension tubing.

The extension tubing holds a small volume of fluid, known as 'dead space'.

After the medication syringe is fully empty, a portion of the active medication still remains inside this extension tubing.

Determine the correct post-administration flushing technique.

The subsequent saline flush must be administered at the same slow rate as the medication itself.

A rapid flush would push the residual medication trapped in the dead space into the bloodstream as a rapid bolus, negating the entire purpose of the initial slow push technique.

Key Concept

IV Push Administration and Tubing Dead Space

Question

Answer

Step-by-Step Solution

Key Concept

Common Mistakes

Topics

More questions from this topic