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Zorluk: OrtaPharmacological and Parenteral Therapies

During a routine shift, a nurse is assigned to a client who requires both nutritional support and antimicrobial therapy. The client currently has total parenteral nutrition (TPN) infusing continuously via a dedicated port of a multi-lumen central venous catheter. A new order is placed for an intermittent infusion of intravenous azithromycin. What is the safest method for the nurse to deliver the newly prescribed medication?

  1. Establish a separate peripheral venous access site specifically for the antibiotic infusion.Cevap
  2. B
    Attach the antibiotic as a secondary piggyback line to the active total parenteral nutrition tubing.
  3. C
    Temporarily halt the nutritional infusion, flush the central line port with sterile saline, administer the drug, and then restart the nutrition.
  4. D
    Inject the prescribed dose of the antibiotic directly into the total parenteral nutrition bag before hanging a new one.

Cevap

The safest method is to establish a separate peripheral venous access site for the antibiotic infusion.
Total parenteral nutrition (TPN) must always be administered through a dedicated intravenous line. Because of its complex composition (high dextrose, amino acids, electrolytes, and sometimes lipids), it has a very high risk of chemical incompatibility and precipitation when mixed with other medications. Furthermore, the line should not be accessed or manipulated unnecessarily due to the high risk of central line-associated bloodstream infections. Establishing a separate peripheral IV is the only safe way to administer the intermittent antibiotic without compromising the TPN.

Adım Adım Çözüm

1
Analyze the client's current intravenous therapy setup.
The client has a continuous TPN infusion running through a dedicated port of a multi-lumen central line.
Understanding the current access is necessary to determine where a new medication can be safely administered.
2
Recall the pharmacological guidelines regarding Total Parenteral Nutrition.
TPN requires a strictly dedicated line and cannot be mixed with or interrupted by other medications.
TPN contains a complex mixture of high-concentration dextrose, amino acids, and electrolytes that easily precipitates when mixed with other drugs. Furthermore, interrupting it causes sudden hypoglycemia.
3
Select the intervention that allows for the antibiotic to be given without violating TPN safety rules.
Establishing a separate peripheral intravenous site is identified as the correct action.
A separate line ensures the antibiotic is delivered on schedule while maintaining the chemical integrity and continuity of the TPN infusion.

Anahtar Kavram

Total Parenteral Nutrition (TPN) Safety and Dedicated IV Lines
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Konular

Pharmacological and Parenteral Therapies

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