The nursing unit receives a client who is being treated for a pulmonary embolism with a continuous intravenous (IV) heparin infusion. The attending provider adds a prescription for intermittent IV vancomycin due to a newly suspected wound infection. During the medication preparation phase, the nurse checks a compatibility chart and identifies that heparin and vancomycin form a precipitate when mixed at the Y-site. The client has only one functioning peripheral venous access catheter.
Which action represents the safest nursing intervention?
- Initiate a second peripheral IV access site to administer the vancomycin independently.Cevap
- BPause the heparin infusion, flush the IV line with sodium chloride, administer the vancomycin, and flush again.
- CAttach the vancomycin secondary tubing to the primary IV line at the Y-site port located closest to the venous access.
- DCalculate a new drip rate to infuse the vancomycin rapidly over to reduce the interruption of the continuous heparin.
Cevap
The most appropriate action is to initiate a second peripheral IV access site to administer the vancomycin independently.
The correct response is to initiate a separate peripheral IV access site. Because heparin and vancomycin are chemically incompatible, they cannot mix in the same tubing. Additionally, heparin is a critical, high-alert medication with a short half-life used to prevent clot extension in a pulmonary embolism; interrupting its continuous infusion to administer a long-infusing medication like vancomycin would place the client at significant risk for worsening thromboembolism.
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Anahtar Kavram
Safe administration of physically incompatible intravenous medications and prioritization of continuous high-alert infusions.