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Soru

Zorluk: OrtaPharmacological and Parenteral Therapies

During the morning assessment of a 1212-day-old neonate, the nurse notes that a continuous intravenous (IV) infusion of Lactated Ringer's solution is actively running. The healthcare provider has just entered a new prescription for an intermittent IV infusion of ceftriaxone. Based on principles of pharmacological safety, which intervention is most appropriate?

  1. A
    Pause the continuous fluids, flush the line with normal saline, administer the antibiotic, and flush again.
  2. B
    Attach the antibiotic to the primary tubing at the Y-site closest to the insertion site.
  3. Withhold the antibiotic and immediately contact the prescribing healthcare provider.Cevap
  4. D
    Verify the weight-based dosage calculation and administer the antibiotic using a syringe pump.

Cevap

The nurse must withhold the ceftriaxone and contact the healthcare provider immediately due to a severe contraindication.
The correct action is to withhold the medication and contact the provider. Ceftriaxone is contraindicated in neonates (≤28\le 28 days old) who are receiving calcium-containing intravenous fluids, such as Lactated Ringer's. The combination can form lethal calcium-ceftriaxone precipitates that deposit in the lungs and kidneys. The nurse must prioritize patient safety and request an alternative antibiotic or a different primary fluid.

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1
Identify the patient population and currently prescribed therapies.
The patient is a neonate (1212 days old) actively receiving Lactated Ringer's (which contains calcium) and is newly prescribed IV ceftriaxone.
Age and concurrent IV fluids are critical factors in assessing pharmacological compatibility and potential adverse reactions.
2
Evaluate the compatibility of ceftriaxone and the concurrent IV fluid.
Ceftriaxone and calcium-containing solutions are absolutely contraindicated in neonates.
Co-administration can cause the formation of fatal calcium-ceftriaxone precipitates that deposit in the neonatal lungs and kidneys.
3
Determine the safest nursing intervention based on the assessment.
The nurse must withhold the medication and collaborate with the provider for a safe alternative.
Nurses have a legal and ethical duty to intercept unsafe prescriptions and prevent patient harm.

Anahtar Kavram

Ceftriaxone and Calcium Incompatibility in Neonates
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Konular

Pharmacological and Parenteral Therapies

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