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Zorluk: OrtaPharmacological and Parenteral Therapies

A client who recently underwent extensive gastrointestinal surgery is receiving continuous total parenteral nutrition (TPN) via a single-lumen central venous catheter. The client reports sudden, severe surgical site pain, and the provider prescribes a one-time dose of intravenous (IV) push morphine. Which of the following is the most appropriate action for the nurse to take?

  1. A
    Administer the morphine directly through the lowest Y-site on the TPN administration set.
  2. B
    Pause the TPN infusion, thoroughly flush the central line with normal saline, push the morphine, and flush again before resuming the TPN.
  3. C
    Contact the pharmacy to verify the chemical compatibility of morphine and the specific TPN formula before proceeding.
  4. Establish a new peripheral intravenous (IV) access site to administer the morphine.Cevap

Cevap

Establish a new peripheral intravenous (IV) access site to administer the morphine.
The correct action is to establish a new peripheral intravenous (IV) access site. Total parenteral nutrition (TPN) is a complex, hypertonic solution that must be administered through a strictly dedicated central line or a dedicated lumen of a multi-lumen catheter. This prevents potentially fatal chemical incompatibilities, physical precipitation, and significantly reduces the risk of central line-associated bloodstream infections (CLABSI). Because the client only has a single-lumen central line, a separate peripheral IV must be initiated to safely administer the prescribed morphine.

Adım Adım Çözüm

1
Analyze the client's current IV access and prescribed therapy.
The client has a single-lumen central line dedicated to a continuous TPN infusion and requires a PRN IV push medication.
Identifying available access points is essential for safe medication administration.
2
Apply the standard nursing safety principles for Total Parenteral Nutrition.
Recognize that TPN must always be administered through a strictly dedicated line or a dedicated lumen of a multi-lumen catheter.
Mixing medications with TPN poses high risks of chemical incompatibility, precipitation, and central line-associated bloodstream infections.
3
Evaluate the available interventions.
Since the existing line cannot be used for the morphine, a new access point must be created.
This is the only way to safely deliver the analgesic without interrupting or compromising the TPN therapy.

Anahtar Kavram

Total parenteral nutrition (TPN) requires a strictly dedicated intravenous line; no other medications or fluids should be administered through the same lumen.
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Pharmacological and Parenteral Therapies

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