A healthcare provider orders intermittent intravenous ceftriaxone for an adult client diagnosed with community-acquired pneumonia. The client's only vascular access is a peripheral catheter currently infusing lactated Ringer's solution at 100 mL/hr. What is the safest action by the nurse regarding the administration of this antibiotic?
- AConnect the antibiotic tubing to the Y-site port above the infusion pump while the primary fluid continues running.
- BPause the primary fluid, infuse the antibiotic as a secondary piggyback, and immediately resume the primary fluid.
- Halt the continuous infusion, flush the line with normal saline, infuse the antibiotic, and flush the line again.Cevap
- DWithhold the medication and contact the healthcare provider to request changing the primary fluid to normal saline.
Cevap
The safest action is to halt the continuous infusion of lactated Ringer's, flush the line with normal saline, infuse the antibiotic, and then flush the line again before restarting the primary fluid.
Ceftriaxone binds chemically with calcium to form a particulate precipitate that can lead to fatal organ damage, particularly in the lungs or kidneys. Because lactated Ringer's solution contains calcium, the two fluids are highly incompatible. When a client has a single IV access site, the standard and safest nursing practice is to pause the incompatible continuous fluid, completely flush the tubing with a neutral, compatible solution (like 0.9% sodium chloride), infuse the medication, and then flush the line again before restarting the primary fluid.
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Ceftriaxone is contraindicated for concurrent administration with calcium-containing intravenous solutions due to the risk of precipitate formation. When managing incompatible medications in a single line, the tubing must be thoroughly flushed with a compatible solution before and after administration.