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Zorluk: OrtaPharmacological and Parenteral Therapies

A nurse is caring for a client with a single-lumen peripheral intravenous (IV) catheter infusing 5%5\% dextrose in water (D5W) at 100 mL/hr100\text{ mL/hr}. The healthcare provider prescribes a STAT dose of IV push haloperidol for severe agitation. The nurse consults a drug compatibility database and notes that haloperidol is physically incompatible with D5W. Which of the following actions should the nurse take to safely administer the medication?

  1. Stop the D5W infusion, flush the IV line with 0.9%0.9\% sodium chloride, administer the haloperidol slowly, flush again with 0.9%0.9\% sodium chloride, and restart the D5W.Cevap
  2. B
    Pause the D5W infusion pump, administer the haloperidol directly into the lowest IV port, and immediately resume the D5W to flush the medication into the vein.
  3. C
    Rapidly administer the haloperidol over 15 seconds15\text{ seconds} into the Y-site port closest to the client to minimize contact time with the D5W fluid.
  4. D
    Dilute the haloperidol in a 10 mL10\text{ mL} syringe of sterile water for injection and administer it slowly through the infusing D5W line.

Cevap

Stop the D5W infusion, flush the IV line with 0.9% sodium chloride, administer the haloperidol slowly, flush again with 0.9% sodium chloride, and restart the D5W.
When an IV push medication is physically incompatible with a continuous IV fluid, the nurse must use the flush-medication-flush technique. The nurse stops the continuous infusion, flushes the line with a compatible fluid (usually 0.9%0.9\% sodium chloride) to clear out the incompatible fluid, administers the medication at the prescribed rate, and then flushes again with the compatible fluid before resuming the original continuous infusion. This prevents dangerous precipitation inside the IV tubing and the client's vein.

Adım Adım Çözüm

1
Identify the physical incompatibility between the prescribed IV push medication and the continuous IV fluid.
The nurse recognizes that haloperidol and D5W cannot mix in the IV tubing.
Mixing incompatible medications or fluids can cause crystallization or precipitation, which can obstruct the catheter or cause a fatal vascular embolism.
2
Stop the incompatible continuous infusion and flush the line with a compatible solution (typically 0.9% sodium chloride).
The D5W is cleared from the IV tubing.
Flushing creates a safe, fluid-free buffer zone in the tubing to prevent the two incompatible substances from coming into physical contact.
3
Administer the IV push medication slowly, followed by a second flush of the compatible solution at the same administration rate.
The medication safely reaches the systemic circulation without precipitating.
The post-administration flush ensures the medication is fully cleared from the line before the incompatible D5W infusion is restarted, preventing mixing.

Anahtar Kavram

Safe administration of incompatible IV push medications via the flush-medication-flush technique
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Konular

Pharmacological and Parenteral Therapies

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