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Difficulty: EasyPharmacological and Parenteral Therapies

A client is receiving continuous total parenteral nutrition (TPN) through a single-lumen central venous catheter. The healthcare provider issues a new prescription for an intravenous (IV) antibiotic. What is the safest action for the nurse to take regarding the administration of this new medication?

  1. Insert a separate peripheral intravenous catheter to administer the antibiotic.Answer
  2. B
    Connect the antibiotic tubing to the lowest Y-port on the current central line.
  3. C
    Stop the nutritional infusion temporarily, flush the line, and infuse the antibiotic.
  4. D
    Inject the antibiotic dose directly into the nutritional formula bag.

Answer

The nurse should insert a separate peripheral intravenous catheter to administer the antibiotic.
Total parenteral nutrition (TPN) has high osmolarity and complex nutrient concentrations, making it highly susceptible to chemical incompatibilities and bacterial growth. Standard nursing practice requires a strictly dedicated line or a dedicated lumen for TPN administration. Because the client currently has a single-lumen catheter, the nurse must establish a new peripheral access site to safely administer the antibiotic.

Step-by-Step Solution

1
Identify the current infusion and its requirements.
The client is receiving total parenteral nutrition (TPN) via a single-lumen central line.
TPN contains high concentrations of glucose, amino acids, and potentially lipids, requiring specific administration protocols.
2
Evaluate the compatibility of the new medication with the existing line.
TPN requires a strictly dedicated line.
Administering medications through a TPN line increases the risk of chemical incompatibility, precipitation, and serious systemic infection.
3
Determine the safest alternative route for the new IV medication.
A new, separate peripheral IV site must be established.
Because the central line is a single lumen currently dedicated to TPN, the antibiotic cannot share this access point.

Key Concept

Total parenteral nutrition (TPN) requires a strictly dedicated intravenous line.
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Topics

Pharmacological and Parenteral Therapies

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