A client admitted with severe sepsis is receiving a continuous intravenous (IV) infusion of norepinephrine through a peripheral IV catheter. The client's current blood pressure is and heart rate is . The healthcare provider prescribes a scheduled dose of IV pantoprazole. After consulting a drug reference, the nurse determines that norepinephrine and pantoprazole are incompatible. Which action should the nurse take?
- Establish a second peripheral IV access site and administer the pantoprazole through the new line.Answer
- BTemporarily pause the norepinephrine infusion, flush the tubing with normal saline, administer the pantoprazole, and flush again.
- CAdminister the pantoprazole through the Y-site closest to the client's IV insertion site to minimize the contact time between the two drugs.
- DAsk the unlicensed assistive personnel (UAP) to assess the client's other arm to find a suitable vein for a new IV line.
Answer
The correct action is to establish a second peripheral IV access site and administer the pantoprazole through the new line.
When a client requires a life-sustaining continuous infusion such as a vasopressor, it cannot be safely paused. Because the newly prescribed medication is incompatible with the continuous infusion, the only safe and effective nursing action is to establish a second IV access site. This ensures the client continues to receive hemodynamic support while safely receiving the prescribed pantoprazole.
Step-by-Step Solution
Key Concept
Management of Incompatible IV Medications and Life-Sustaining Infusions