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Difficulty: MediumPharmacological and Parenteral Therapies

A registered nurse (RN) is preparing to administer intravenous (IV) medications and fluids to a critically ill client. Which of the following actions by the RN demonstrate safe pharmacological and parenteral therapy practices? Select all that apply.

  1. Flushing the intravenous access with 0.9%0.9\% sodium chloride before and after administering an IV push medication.Answer
  2. B
    Pausing a continuous heparin infusion to administer an intermittent IV piggyback antibiotic through the same Y-site.
  3. Using an electronic infusion pump to deliver high-alert intravenous medications, such as concentrated potassium chloride.Answer
  4. D
    Calculating the drip rate for a weight-based vasoactive infusion using the client's stated weight from a previous hospital admission.
  5. Assessing the continuous IV fluid bag for clarity, expiration date, and the absence of precipitate prior to administration.Answer

Answer

The correct actions include flushing the IV line before and after push medications, using an infusion pump for high-alert medications, and visually inspecting IV fluids prior to administration.
Safe parenteral therapy involves confirming fluid integrity, using electronic pumps for high-alert medications to control flow rates, and flushing lines to prevent chemical incompatibility.

Step-by-Step Solution

1
Evaluate the safety of flushing the IV access.
This is a correct action.
Flushing with 0.9%0.9\% sodium chloride maintains patency and prevents chemical interactions between incompatible medications.
2
Evaluate the safety of interrupting a continuous heparin infusion for a piggyback medication.
This is an incorrect action.
Heparin is a high-alert medication that requires a dedicated line to maintain therapeutic levels and prevent compatibility issues at the Y-site.
3
Evaluate the necessity of an infusion pump for potassium chloride.
This is a correct action.
Potassium chloride is a high-alert medication that can cause fatal arrhythmias if infused too rapidly; an electronic pump ensures a strictly controlled rate.
4
Evaluate the method for determining weight in weight-based dosing calculations.
This is an incorrect action.
Relying on historical or estimated weight for critical care drips can lead to severe miscalculations. A current, actual weight must always be used.
5
Evaluate the procedure for inspecting IV fluids.
This is a correct action.
Checking for clarity, precipitates, and expiration dates prevents the administration of contaminated or degraded parenteral solutions.

Key Concept

Safe administration of parenteral therapies requires strict adherence to compatibility guidelines, accurate mathematical dosing based on current data, and continuous evaluation of equipment and fluid integrity.
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Topics

Pharmacological and Parenteral Therapies

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