Examkin

Question

Difficulty: EasyPharmacological and Parenteral Therapies

During morning rounds, the nurse notes that a client with severe malnutrition has total parenteral nutrition (TPN) infusing through a single-lumen peripherally inserted central catheter (PICC). A new prescription for intermittent intravenous (IV) ceftriaxone is ordered for a suspected infection. Which action is the most appropriate method to deliver the antibiotic?

  1. Establish a new peripheral intravenous access site to administer the ceftriaxone.Answer
  2. B
    Connect the ceftriaxone infusion to the Y-site port closest to the client's PICC insertion site.
  3. C
    Stop the TPN briefly, flush the PICC line with sterile normal saline, infuse the antibiotic, and restart the TPN.
  4. D
    Request that the hospital pharmacy add the ceftriaxone dose directly into the current TPN bag.

Answer

Establish a new peripheral intravenous access site to administer the ceftriaxone.
Total parenteral nutrition (TPN) contains complex mixtures of amino acids, dextrose, lipids, and electrolytes. Because of its high osmolarity and composition, it carries a significant risk of chemical incompatibility when mixed with other medications. Therefore, TPN must always be administered through a dedicated IV line or a dedicated lumen of a multi-lumen central catheter. Since the client only has a single-lumen PICC, the nurse must establish a separate peripheral IV site to safely give the antibiotic.

Step-by-Step Solution

1
Identify the current IV setup and the new prescription.
The client has a single-lumen PICC dedicated to TPN, and needs a new IV antibiotic.
Understanding the existing access is required before safely giving new IV medications.
2
Recall the safety guidelines for TPN administration.
TPN must always run through a dedicated line or a dedicated lumen of a multi-lumen central catheter.
TPN solutions are highly complex, have a high osmolarity, and pose a high risk for infection and chemical incompatibility with other drugs.
3
Determine the safest method to administer the newly prescribed antibiotic.
Because the single-lumen PICC is currently dedicated to TPN, the nurse must start a new peripheral IV line.
This prevents mixing the antibiotic with TPN and avoids pausing the TPN, which could lead to hypoglycemia.

Key Concept

Total Parenteral Nutrition (TPN) requires a dedicated intravenous line to prevent severe drug incompatibility and infection.
Rate this question

Topics

Pharmacological and Parenteral Therapies

More questions from this topic