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Zorluk: ZorPharmacological and Parenteral Therapies

A nurse is caring for a client with a confirmed pulmonary embolism who is receiving a continuous intravenous (IV) infusion of heparin at 18 units/kg/hr18 \text{ units/kg/hr} through a single-lumen peripheral venous catheter. The healthcare provider prescribes a scheduled dose of IV levofloxacin 500 mg500 \text{ mg} to infuse over 60 minutes60 \text{ minutes} for a concurrent bacterial pneumonia. Upon reviewing a pharmacological reference, the nurse discovers that heparin and levofloxacin are physically incompatible. Which of the following is the most appropriate action by the nurse?

  1. Insert a new peripheral venous catheter in a different extremity to administer the levofloxacin.Cevap
  2. B
    Stop the heparin infusion, flush the catheter with normal saline, infuse the levofloxacin, flush again, and resume the heparin.
  3. C
    Attach the levofloxacin secondary tubing to the primary tubing Y-site port closest to the client's insertion site.
  4. D
    Administer the levofloxacin simultaneously with the heparin by utilizing a dual-channel intravenous infusion pump.

Cevap

Insert a new peripheral venous catheter in a different extremity to administer the levofloxacin.
The correct action is to establish a new peripheral intravenous access site. Because heparin and levofloxacin are physically incompatible, they cannot be mixed in the same IV tubing or single-lumen catheter without risking crystallization and precipitation. Furthermore, because heparin is a critical high-alert medication with a very short half-life, pausing the infusion for the 60 minutes required to administer the antibiotic would place the client at immediate risk for thrombus extension.

Adım Adım Çözüm

1
Analyze the pharmacological properties of the current continuous infusion.
Heparin has a very short half-life and is critical for preventing thrombus extension in a client with a pulmonary embolism.
To determine if the infusion can be safely interrupted for secondary medication administration.
2
Evaluate the physical compatibility of the prescribed medications.
Heparin and levofloxacin are physically incompatible.
To determine if the medications can be administered simultaneously through the same intravenous line.
3
Formulate a safe administration plan based on the client's vascular access.
The client only has a single-lumen catheter. A second intravenous access site must be established.
Mixing incompatible drugs causes precipitation, and pausing a critical heparin infusion for 60 minutes severely compromises patient safety.

Anahtar Kavram

Intravenous Medication Compatibility and Continuous Infusion Safety
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Konular

Pharmacological and Parenteral Therapies

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