A nurse is preparing to administer an intermittent intravenous (IV) antibiotic via a secondary line (piggyback) to a client who is currently receiving a continuous primary IV fluid infusion. Arrange the following steps for setting up and initiating the secondary infusion in the correct chronological order.
- 1Close the roller clamp on the new secondary intravenous administration tubing.
- 2Insert the spike of the secondary tubing into the entry port of the secondary medication bag.
- 3Prime the secondary tubing by slowly opening the roller clamp until the line is completely filled with fluid.
- 4Scrub the uppermost Y-site port on the primary intravenous tubing with an antiseptic swab.
- 5Attach the secondary tubing to the primary line and hang the primary fluid bag lower than the secondary bag.
Answer
The correct procedural sequence is: 1) Close the roller clamp on the secondary tubing, 2) Spike the secondary medication bag, 3) Prime the secondary tubing, 4) Scrub the uppermost Y-site port on the primary line, and 5) Attach the tubing and lower the primary fluid bag.
Safe initiation of an IV piggyback requires preparing the equipment before breaking into the patient's existing line. The nurse must first secure the clamp to prevent fluid loss, spike the bag, and prime the air from the line. Once the secondary set is fully prepared, the nurse cleanses the patient's primary line to maintain sterility, connects the secondary line, and manipulates the physical height of the bags to ensure the medication infuses correctly via gravity.
Step-by-Step Solution
Key Concept
Safe administration and procedural sequencing of secondary intravenous (IV piggyback) medications.