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Zorluk: OrtaPharmacological and Parenteral Therapies

A client admitted with severe sepsis is receiving a continuous intravenous (IV) infusion of norepinephrine through a peripheral IV catheter. The client's current blood pressure is 88/54 mm Hg88/54 \text{ mm Hg} and heart rate is 112 beats/min112 \text{ beats/min}. The healthcare provider prescribes a scheduled dose of IV pantoprazole. After consulting a drug reference, the nurse determines that norepinephrine and pantoprazole are incompatible. Which action should the nurse take?

  1. Establish a second peripheral IV access site and administer the pantoprazole through the new line.Cevap
  2. B
    Temporarily pause the norepinephrine infusion, flush the tubing with normal saline, administer the pantoprazole, and flush again.
  3. C
    Administer the pantoprazole through the Y-site closest to the client's IV insertion site to minimize the contact time between the two drugs.
  4. D
    Ask the unlicensed assistive personnel (UAP) to assess the client's other arm to find a suitable vein for a new IV line.

Cevap

The correct action is to establish a second peripheral IV access site and administer the pantoprazole through the new line.
When a client requires a life-sustaining continuous infusion such as a vasopressor, it cannot be safely paused. Because the newly prescribed medication is incompatible with the continuous infusion, the only safe and effective nursing action is to establish a second IV access site. This ensures the client continues to receive hemodynamic support while safely receiving the prescribed pantoprazole.

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1
Identify the primary clinical problem and constraints.
The client is hypotensive and dependent on a continuous norepinephrine infusion. The prescribed pantoprazole is incompatible with norepinephrine.
Understanding drug incompatibilities and the client's hemodynamic dependence on vasopressors is essential for safe medication administration.
2
Evaluate the risk of pausing the continuous infusion.
Stopping norepinephrine, even briefly, can lead to a precipitous drop in blood pressure and profound shock.
Life-sustaining infusions must remain continuous to support circulation.
3
Determine the safest method to administer the incompatible medication.
A new, separate IV line must be inserted.
This prevents mixing incompatible drugs and allows the vasopressor to run uninterrupted.

Anahtar Kavram

Management of Incompatible IV Medications and Life-Sustaining Infusions
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