Question

A client in severe heart failure has a heparin drip infusing. The health care provider prescribes nesiritide (Natrecor) to be given intravenously. Which intervention is essential before administration of this medication?

a. Insert a separate IV access.
b. Prepare a test bolus dose.
c. Prepare the piggyback line.
d. Administer furosemide (Lasix) first.

Answer 1

Before administering nesiritide (Natrecor), a separate IV access must be inserted to avoid interactions with other medications such as heparin. IV solutions are carefully formulated to match blood osmolarity for patient safety. Checklists are used to ensure proper IV administration techniques.

Step-by-step explanation:

Before administering nesiritide (Natrecor), which is used to treat severely decompensated congestive heart failure, it is essential to insert a separate IV access. Nesiritide is administered via a continuous intravenous infusion and it should not be mixed or infused with other drugs, which is why a separate IV line is necessary. This ensures that the medication is delivered properly and avoids potential interactions with other medications, such as heparin, that might be infusing concurrently through a different line.

For dehydrated patients requiring intravenous fluids, an isotonic solution such as normal saline or a balanced electrolyte solution is typically given. In cases of hypokalemia, a physician may order an intravenous delivery of a specific concentration of potassium chloride (KCl), such as 0.5% KCl. These solutions must be properly formulated in terms of osmolarity to prevent hemolysis of red blood cells.

When dealing with intravenous drug administration, protocols like checklists can be vital for ensuring patient safety and proper procedure following, as evidenced by Dr. Pronovost's experiment in the ICU with a checklist to prevent central line infections.