A client receiving continuous total parenteral nutrition (TPN) via a single-lumen peripherally inserted central catheter (PICC) suddenly develops acute pulmonary edema. The client's oxygen saturation drops to on room air, and the nurse auscultates bilateral crackles. The healthcare provider prescribes a stat dose of intravenous furosemide . The available furosemide concentration is . Which of the following is the most appropriate action by the nurse?
- Insert a peripheral intravenous catheter and administer of the furosemide solution over to minutes.Answer
- BAdminister of the furosemide solution directly into the lowest Y-site of the total parenteral nutrition tubing to ensure rapid central circulation.
- CPause the total parenteral nutrition, flush the catheter with sodium chloride, administer of furosemide, flush again, and resume the infusion.
- DElevate the head of the bed, apply oxygen via a non-rebreather mask, and wait for the oxygen saturation to improve before giving the diuretic.
Answer
The nurse must insert a new peripheral intravenous catheter and administer of furosemide slowly over to minutes.
The correct action involves three critical safety principles. First, the nurse accurately calculates the dose volume as (). Second, the nurse applies the pharmacological knowledge that furosemide must be administered slowly to prevent ototoxicity, making a to -minute push appropriate. Finally, the nurse recognizes that total parenteral nutrition (TPN) requires a strictly dedicated line due to the extreme risk of chemical incompatibility and precipitation. Because the client only has a single-lumen PICC, establishing a new peripheral intravenous catheter is the only safe method to administer the life-saving medication.
Step-by-Step Solution
Key Concept
Safe Parenteral Medication Administration and TPN Principles