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Zorluk: OrtaPharmacological and Parenteral Therapies

A nurse is caring for a client who is receiving a continuous transfusion of packed red blood cells (PRBCs) through a primary peripheral intravenous (IV) catheter. The client's latest laboratory results reveal a critically low serum potassium level of 2.3 mEq/L, and the healthcare provider prescribes a dose of 40 mEq of IV potassium chloride. A second, saline-locked peripheral IV access is available on the client's other arm. Which of the following is the safest nursing action to implement?

  1. A
    Administer the potassium chloride as a slow, direct IV push into the saline-locked access over a minimum of 5 to 10 minutes.
  2. B
    Attach the potassium chloride as a secondary piggyback infusion to the IV line currently administering the packed red blood cells.
  3. Connect a pre-mixed potassium chloride infusion to the saline-locked IV access and administer it via an electronic pump at a maximum rate of 10 mEq per hour.Cevap
  4. D
    Initiate the potassium infusion through the saline-locked access and instruct the unlicensed assistive personnel to assess the site hourly for phlebitis.

Cevap

Connect a pre-mixed potassium chloride infusion to the saline-locked IV access and administer it via an electronic pump at a maximum rate of 10 mEq per hour.
The safest and standard practice for administering intravenous potassium chloride is to use a pre-mixed solution (to avoid mixing errors) and administer it via an electronic infusion pump. For a peripheral intravenous line, the maximum safe infusion rate is 10 mEq per hour to prevent burning at the site and to avoid life-threatening cardiac arrhythmias.

Adım Adım Çözüm

1
Evaluate the prescribed medication and the client's current intravenous access.
The client requires a high-alert medication (40 mEq of IV potassium chloride). One IV line is infusing blood products, and a second line is saline-locked and available for use.
Identifying available access points is essential to prevent medication incompatibilities and ensure safe delivery.
2
Determine the safe administration rate and method for intravenous potassium chloride.
Potassium chloride must be properly diluted and administered via an infusion pump. The rate must not exceed 10 mEq per hour through a peripheral line.
Rapid infusion or direct IV push of potassium causes fatal cardiac arrhythmias.
3
Identify contraindications related to the current blood transfusion and delegation rules.
Potassium cannot be mixed with blood products, and the RN must personally assess the IV site for complications during the infusion.
Blood products are only compatible with 0.9% sodium chloride. Furthermore, assessing an IV site for vesicant extravasation requires nursing clinical judgment and cannot be delegated.

Anahtar Kavram

Intravenous potassium chloride administration safety, compatibility, and nursing delegation.
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