A registered nurse is preparing to administer a prescribed dose of intravenous (IV) push furosemide to a client. The client is currently receiving a continuous IV infusion of milrinone. A drug reference guide indicates that furosemide and milrinone are incompatible, and the client has only one peripheral IV access site. What is the correct sequence of actions for the nurse to safely administer the furosemide?
- 1Stop the continuous IV infusion of milrinone.
- 2Clean the injection port closest to the client and flush with 10 mL of 0.9% sodium chloride.
- 3Administer the IV push furosemide over 1 to 2 minutes.
- 4Flush the injection port with 10 mL of 0.9% sodium chloride at the same rate the furosemide was administered.
- 5Restart the continuous IV infusion of milrinone.
Cevap
The correct sequence is to first stop the milrinone infusion, flush the line with normal saline to clear the incompatible drug, administer the furosemide over the recommended time, flush again with normal saline at the same slow rate, and finally restart the continuous milrinone infusion.
When administering an IV push medication through a line running an incompatible continuous infusion, the nurse must prevent the two medications from mixing to avoid precipitation. The correct sequence is to first stop the continuous infusion. Next, flush the line with a compatible solution (such as 0.9% sodium chloride) using the port closest to the patient to clear out the primary drug. Then, administer the IV push medication. After administration, flush the line again with the compatible solution at the same slow rate as the medication to safely clear the tubing without causing a bolus effect. Finally, the continuous infusion is restarted.
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Anahtar Kavram
Safe administration of an IV push medication through an incompatible continuous IV line requires stopping the primary infusion and flushing the line with a compatible solution both before and after the medication is given.