Examkin

Question

Difficulty: MediumPharmacological and Parenteral Therapies

Ten minutes after the initiation of an intravenous (IV) piperacillin-tazobactam infusion, a client develops audible inspiratory stridor, restlessness, and lightheadedness. The client's heart rate is 128 bpm128\text{ bpm} and blood pressure is 84/50 mmHg84/50\text{ mmHg}. Which of the following priority actions should the nurse implement? Select all that apply.

  1. Stop the piperacillin-tazobactam infusion and disconnect the current intravenous tubing.Answer
  2. Prepare to administer prescribed intramuscular epinephrine.Answer
  3. Initiate a rapid infusion of 0.9%0.9\% sodium chloride using new intravenous tubing.Answer
  4. D
    Administer an intravenous normal saline flush through the primary tubing to maintain line patency.
  5. E
    Position the client upright with their legs dangling over the edge of the bed.
  6. F
    Complete a comprehensive respiratory assessment before calling the rapid response team.

Answer

The correct actions are to stop the infusion and disconnect the tubing, prepare intramuscular epinephrine, and initiate a rapid infusion of 0.9% sodium chloride using new tubing.
Anaphylaxis is a severe, life-threatening hypersensitivity reaction. The immediate priority is to stop the offending agent and disconnect the tubing to prevent any more medication from entering the client. Intramuscular epinephrine is the primary pharmacological treatment to reverse bronchoconstriction (stridor) and cardiovascular collapse. Additionally, rapid infusion of isotonic crystalloids (like 0.9%0.9\% sodium chloride) through entirely new IV tubing is required to expand intravascular volume and correct profound hypotension.

Step-by-Step Solution

1
Identify the client's clinical presentation.
The client is exhibiting stridor, tachycardia, and severe hypotension (84/50 mmHg84/50\text{ mmHg}).
These are hallmark signs of anaphylactic shock, a life-threatening allergic reaction to the IV antibiotic.
2
Determine the immediate priority regarding the IV medication.
Stop the piperacillin-tazobactam infusion and disconnect the tubing completely.
Halting the administration of the allergen is the most critical first step to prevent further physiological deterioration.
3
Identify indicated pharmacological and hemodynamic interventions.
Prepare intramuscular epinephrine and administer IV fluids through new, uncontaminated tubing.
Epinephrine is required to reverse airway edema and cardiovascular collapse, while IV fluids treat the profound hypotension caused by massive vasodilation.

Key Concept

Anaphylaxis Management in Parenteral Therapy
Rate this question

Topics

Pharmacological and Parenteral Therapies

More questions from this topic