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Difficulty: EasyPharmacological and Parenteral Therapies

A client admitted with bacterial pneumonia is prescribed an intermittent intravenous (IV) antibiotic. The client currently has a continuous peripheral IV infusion of dextrose 5% in water (D5W) running at a low rate. Which actions are required by the nurse to ensure safe administration of the medication? Select all that apply.

  1. Assess the IV insertion site for signs of infiltration or phlebitis before attaching the antibiotic.Answer
  2. B
    Determine medication compatibility by verifying that both the antibiotic and the continuous fluid are clear and colorless.
  3. Verify the client's identity using two unique identifiers, such as the full name and date of birth.Answer
  4. D
    Delegate the task of observing the client for initial signs of an allergic reaction to the unlicensed assistive personnel.
  5. E
    Mentally estimate the required drops per minute for the infusion instead of performing a written or electronic calculation.
  6. Review the client's health record to confirm there are no documented allergies to the prescribed medication class.Answer

Answer

The correct actions are assessing the IV site, verifying the client's identity using two unique identifiers, and checking the health record for documented allergies.
Safe parenteral therapy requires strict adherence to the rights of medication administration, including verifying the right patient with two identifiers, checking for allergies, and assessing the physical IV site to prevent complications like extravasation.

Step-by-Step Solution

1
Verify patient safety standards before administration.
Confirming the patient's identity with two identifiers and checking for medication allergies ensures the 'right patient' and 'right medication' principles are met.
These are non-negotiable standards of practice for all pharmacological therapies to prevent medical errors.
2
Assess the physical route of administration.
Inspecting the peripheral IV site confirms patency and absence of complications.
Administering medications into an infiltrated or inflamed vein can cause severe local tissue damage or systemic complications.
3
Identify unsafe clinical practices.
Recognize that estimating drip rates, relying on visual fluid checks for compatibility, and delegating initial assessments are unsafe.
Evidence-based practice requires precise mathematical calculations, the use of approved compatibility resources, and RN-level clinical judgment for initial assessments.

Key Concept

Safe Administration of Parenteral Therapies
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Topics

Pharmacological and Parenteral Therapies

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