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Zorluk: ZorPharmacological and Parenteral Therapies

A nurse is caring for a 65-year-old client admitted with a heart failure exacerbation and a suspected systemic infection. The client has a continuous peripheral intravenous (IV) infusion of Lactated Ringer's solution running at 75 mL/hr. The client's current vital signs are blood pressure 138/85 mmHg, heart rate 92 beats/min, and respiratory rate 18 breaths/min. The healthcare provider has prescribed several new IV medications to manage the client's condition. Which of the following actions by the nurse demonstrate safe pharmacological and parenteral therapy principles? Select all that apply.

  1. Verifying Y-site compatibility in an approved drug reference prior to administering an intravenous push dose of ondansetron for nausea.Cevap
  2. B
    Initiating an intravenous piggyback of ceftriaxone to infuse concurrently with the continuous Lactated Ringer's solution.
  3. Administering a prescribed intravenous push dose of furosemide slowly at a rate not exceeding 20 mg per minute.Cevap
  4. D
    Setting the infusion pump to deliver a 20 mEq potassium chloride piggyback over 15 minutes to correct a serum potassium level of 3.2 mEq/L.
  5. Flushing the intravenous catheter with preservative-free 0.9% sodium chloride before and after administering an incompatible medication.Cevap
  6. F
    Delegating the routine assessment of the peripheral intravenous insertion site for signs of phlebitis to the unlicensed assistive personnel (UAP).

Cevap

The correct actions include verifying Y-site compatibility, administering furosemide slowly to prevent ototoxicity, and flushing the intravenous line with 0.9% sodium chloride before and after giving incompatible medications.
Safe parenteral therapy requires strict adherence to administration guidelines to prevent life-threatening complications. Verifying Y-site compatibility is an essential pre-administration assessment to prevent adverse interactions in the intravenous tubing. Administering intravenous furosemide slowly (not exceeding 20 mg/minute) is necessary to prevent speed shock and ototoxicity. When administering an incompatible medication through an existing line, the nurse must adequately flush the catheter with 0.9% sodium chloride before and after the dose to ensure the incompatible drugs do not mix.

Adım Adım Çözüm

1
Analyze the compatibility of prescribed medications with the continuous Lactated Ringer's infusion.
Recognize that ceftriaxone is strictly incompatible with calcium-containing Lactated Ringer's, while the compatibility of other medications like ondansetron must be verified before administration.
Preventing fatal intravenous precipitates is a critical priority in parenteral therapy.
2
Evaluate the safe administration rates for high-alert intravenous medications.
Determine that potassium chloride must not exceed 10 mEq/hr peripherally, and furosemide must be pushed slowly at a maximum rate of 20 mg/min.
Rapid administration of potassium causes life-threatening cardiac dysrhythmias, and rapid furosemide causes ototoxicity.
3
Determine the appropriate scope of practice regarding intravenous therapy monitoring.
Identify that assessing an intravenous site for complications like phlebitis or infiltration requires clinical judgment.
The registered nurse remains accountable for patient assessment and cannot delegate this task to unlicensed assistive personnel.

Anahtar Kavram

Safe Parenteral Therapy and Medication Administration Principles
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Konular

Pharmacological and Parenteral Therapies

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