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Difficulty: EasyPharmacological and Parenteral Therapies

A nurse is preparing to administer a scheduled dose of intravenous (IV) piggyback ceftriaxone to a client admitted with pneumonia. The client currently has a continuous IV infusion of parenteral nutrition (PN) running at 75 mL/hr75\text{ mL/hr} through a central venous catheter. Which action must the nurse prioritize first?

  1. Verify the compatibility of ceftriaxone with the parenteral nutrition using a drug reference guide.Answer
  2. B
    Prime the secondary tubing with the ceftriaxone and attach it to the port closest to the client.
  3. C
    Calculate the exact infusion rate for the ceftriaxone based on the prescribed dose and delivery time.
  4. D
    Assign the unlicensed assistive personnel (UAP) to monitor the central venous catheter site for complications.

Answer

The nurse must first verify the compatibility of ceftriaxone with the parenteral nutrition using a drug reference guide.
The most critical priority when administering multiple intravenous fluids or medications through a single line is to ensure they are chemically and physically compatible. Parenteral nutrition is a highly complex nutritional mixture that is incompatible with a wide variety of medications. Verifying compatibility prevents the formation of precipitates, which can occlude the central venous catheter or cause a fatal embolism in the client.

Step-by-Step Solution

1
Identify the primary continuous infusion and the prescribed secondary medication.
The client is receiving complex parenteral nutrition (PN) continuously and is prescribed a secondary IV piggyback antibiotic.
Recognizing that multiple IV fluids will be infusing through the same central line access prompts the need for an immediate safety check.
2
Prioritize nursing actions based on fundamental safety principles.
Safety checks must precede any procedural setup, calculation, or delegation.
Administering incompatible medications can result in line occlusion from precipitation, drug inactivation, or systemic harm to the client.
3
Select the intervention that addresses the most critical physiological safety risk.
Checking a drug reference guide for compatibility is determined to be the absolute first priority action.
Compatibility must be established definitively before taking any physical steps to administer the medication.

Key Concept

IV Medication Compatibility and Administration Safety
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Topics

Pharmacological and Parenteral Therapies

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