A nurse is caring for a client with a pulmonary embolism who is receiving a continuous heparin infusion through a single peripheral IV catheter. The healthcare provider has newly prescribed intermittent IV vancomycin to treat a concurrent cellulitis infection. Which of the following actions should the nurse take to safely administer these therapies? Select all that apply.
- Insert a new, separate peripheral IV catheter to administer the vancomycin infusion.Answer
- BConnect the vancomycin infusion directly to the lowest Y-site port on the primary heparin tubing.
- Verify the client's most recent serum creatinine level and vancomycin trough results before initiating the infusion.Answer
- DPause the continuous heparin infusion for 90 minutes to allow the vancomycin to infuse, then resume the heparin.
- Assess the new IV insertion site for blood return and absence of swelling prior to starting the antibiotic.Answer
- FDetermine the vancomycin pump setting in mL/hr by dividing the ordered dose in milligrams by the prescribed infusion time in hours.
Answer
The correct actions are inserting a separate IV catheter for the vancomycin, verifying serum creatinine and trough levels, and assessing the new IV site for patency prior to administration.
Safe administration of vancomycin requires monitoring for nephrotoxicity (by checking creatinine and trough levels) and preventing tissue necrosis by confirming IV patency, as it is a vesicant. Because vancomycin and heparin are physically incompatible, and pausing heparin in a client with a pulmonary embolism is unsafe, a separate IV line must be established for the antibiotic.
Step-by-Step Solution
Key Concept
Safe parenteral medication administration requires verifying Y-site compatibility, prioritizing the maintenance of critical continuous infusions, and monitoring for specific drug toxicities such as nephrotoxicity and tissue extravasation.
Estimated Time:1m 30s