A nurse is preparing to administer an intermittent intravenous (IV) piggyback medication using the backpriming method through an existing continuous primary IV infusion. Assuming hand hygiene and medication verification have been completed, place the following steps in the correct sequence for setting up the IV piggyback.
- 1Close the roller clamp on the secondary IV tubing and spike the secondary medication bag.
- 2Scrub the needleless connector on the primary IV tubing located above the infusion pump.
- 3Attach the secondary IV tubing to the cleansed primary port and lower the secondary bag below the primary fluid bag.
- 4Open the secondary roller clamp to allow primary IV fluid to flow backward into the secondary tubing until the drip chamber is half full.
- 5Close the secondary roller clamp, hang the secondary bag higher than the primary bag, and program the infusion pump.
Answer
The correct sequence is: 1) Close the clamp and spike the bag, 2) Scrub the primary port, 3) Attach and lower the secondary bag, 4) Open the clamp to backprime, and 5) Close the clamp, hang the bag, and program the pump.
The correct sequence ensures patient safety, maintains asepsis, and prevents medication waste. By closing the clamp before spiking, the system remains closed. Scrubbing the hub is a mandatory aseptic step before any connection. Lowering the secondary bag below the primary bag creates the necessary hydrostatic pressure gradient. When the clamp is opened, the primary fluid flows backward, clearing air from the secondary line without wasting medication. Finally, closing the clamp and hanging the bag high allows the medication to infuse first when the pump is programmed.
Step-by-Step Solution
Key Concept
Intravenous Piggyback (IVPB) Backpriming Procedure
Estimated Time:1m 30s