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Zorluk: OrtaPharmacological and Parenteral Therapies

An adult client admitted with suspected sepsis is receiving a continuous intravenous infusion of lactated Ringer's solution at 150 mL/hr150\text{ mL/hr} through a single peripheral intravenous line. The healthcare provider prescribes a stat dose of intravenous ceftriaxone 1 g1\text{ g} in 50 mL50\text{ mL} of 0.9% sodium chloride to be infused over 30 minutes. Which action is most appropriate for the nurse to take?

  1. Stop the lactated Ringer's infusion, flush the line with 0.9% sodium chloride, infuse the ceftriaxone, and flush the line again before resuming the primary fluids.Cevap
  2. B
    Connect the ceftriaxone infusion tubing to the Y-site port closest to the client's insertion site while the lactated Ringer's is actively infusing.
  3. C
    Calculate the secondary infusion pump rate at 200 mL/hr200\text{ mL/hr} to ensure the antibiotic is delivered as rapidly as possible for the septic client.
  4. D
    Withhold the antibiotic administration until a central venous catheter can be placed, as peripheral administration of ceftriaxone is contraindicated.

Cevap

Stop the lactated Ringer's infusion, flush the line with 0.9% sodium chloride, infuse the ceftriaxone, and flush the line again before resuming the primary fluids.
The correct action demonstrates knowledge of intravenous compatibility and safe administration principles. Ceftriaxone binds with calcium to form particulate matter (precipitate). Because lactated Ringer's contains calcium, the two cannot mix in the same line. If only one intravenous site is available, the nurse must temporarily pause the primary fluid, clear the line with a compatible flush (0.9% sodium chloride), administer the medication, and flush the line again before resuming the primary fluid.

Adım Adım Çözüm

1
Identify the primary infusion and the prescribed secondary medication.
The client is receiving lactated Ringer's (which contains calcium) and is prescribed ceftriaxone.
Recognizing the specific intravenous fluids and medications is the first step in assessing for compatibility.
2
Determine the compatibility of ceftriaxone and lactated Ringer's.
Ceftriaxone and calcium-containing solutions (like lactated Ringer's) are incompatible and will form precipitates.
Simultaneous administration of incompatible intravenous medications can cause crystal formation, leading to line occlusion or fatal emboli.
3
Formulate a safe administration plan given the single intravenous line.
The nurse must stop the primary fluid, flush the line with a compatible solution (0.9% sodium chloride), administer the antibiotic, and flush again.
Sequential administration with thorough flushing prevents the incompatible substances from mixing in the intravenous tubing.

Anahtar Kavram

Ceftriaxone is incompatible with calcium-containing intravenous solutions and must be administered sequentially with thorough flushing if a dedicated line is unavailable.
Tahmini Süre:1m 30s
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Pharmacological and Parenteral Therapies

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