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Zorluk: OrtaPharmacological and Parenteral Therapies

A client with an intra-abdominal infection is receiving a continuous intravenous infusion of metronidazole. The client reports severe nausea, and the healthcare provider prescribes a dose of intravenous ondansetron. The client has a single peripheral intravenous line. After consulting a pharmacological reference, the nurse identifies that metronidazole and ondansetron are incompatible at the Y-site. Which action should the nurse take to safely administer the prescribed antiemetic?

  1. A
    Administer the ondansetron via a rapid intravenous push into the most proximal port to minimize the contact time between the two medications.
  2. B
    Withhold the ondansetron and contact the healthcare provider to request an oral antiemetic to prevent interrupting the antibiotic therapy.
  3. Pause the continuous infusion, flush the line with 0.9% sodium chloride, administer the ondansetron, flush the line again, and resume the continuous infusion.Cevap
  4. D
    Calculate the tubing's dead space volume and administer the ondansetron slowly, relying on the fluid volume to keep the medications separated.

Cevap

Pause the continuous infusion, flush the line with 0.9% sodium chloride, administer the ondansetron, flush the line again, and resume the continuous infusion.
When an intravenous medication must be administered through a line currently infusing an incompatible solution, the nurse must prevent the two substances from mixing. If the primary infusion can be safely paused (as is the case with most continuous antibiotics), the standard procedure is to stop the pump, flush the line with a compatible fluid like 0.9% sodium chloride, administer the secondary medication, and flush the line again before resuming the primary infusion. This technique effectively clears the tubing and maintains parenteral safety.

Adım Adım Çözüm

1
Identify the incompatibility between the continuous metronidazole infusion and the prescribed intravenous ondansetron.
Recognize that the two medications cannot mix in the intravenous tubing.
Mixing incompatible medications can cause crystallization or precipitation, which can lead to a loss of drug efficacy or a dangerous embolism.
2
Evaluate the clinical safety of pausing the primary infusion.
Determine that pausing an antibiotic infusion for a few minutes is clinically safe and acceptable.
Unlike continuous vasopressors or antiarrhythmics, antibiotics do not cause immediate hemodynamic instability if briefly paused.
3
Execute the flush-administer-flush protocol.
Clear the line with a compatible solution (e.g., normal saline), administer the antiemetic, and clear the line again before restarting the primary infusion.
This physical separation ensures the incompatible drugs never come into contact with each other.

Anahtar Kavram

Intravenous Medication Compatibility and Safe Administration Practices
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Konular

Pharmacological and Parenteral Therapies

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