A client diagnosed with short bowel syndrome is receiving continuous total parenteral nutrition (TPN) via a single-lumen peripherally inserted central catheter (PICC). The healthcare provider prescribes an intermittent intravenous dose of famotidine to be administered every 12 hours. Which action should the nurse take to safely administer this medication?
- Insert a new peripheral intravenous catheter and administer the famotidine through the new line.Cevap
- BAttach the famotidine to the lowest Y-site port on the primary TPN tubing to minimize the contact time between the solutions.
- CPause the TPN infusion, thoroughly flush the PICC with normal saline, administer the famotidine, and then resume the TPN.
- DRecalculate the famotidine infusion rate to match the continuous TPN rate to prevent fluid volume overload during simultaneous administration.
Cevap
The nurse must establish a separate peripheral intravenous line for the administration of the famotidine.
Total parenteral nutrition (TPN) contains a complex mixture of glucose, amino acids, lipids, and electrolytes that is highly susceptible to precipitate formation when mixed with other medications. Additionally, due to the high glucose content, the line is at a significant risk for bacterial growth. Evidence-based nursing practice mandates that TPN must be administered through a completely dedicated intravenous line or a dedicated port of a multi-lumen central line. Because this client has only a single-lumen PICC currently dedicated to the TPN, it cannot be used for any other medications. The only safe and appropriate action is to establish a new, separate peripheral intravenous access to administer the famotidine.
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Anahtar Kavram
Total parenteral nutrition (TPN) must always be administered through a strictly dedicated intravenous line or lumen to prevent medication incompatibilities, precipitation, and infection.