Question

The nursing instructor is reviewing IV medication administration with the nursing students. Which of the following statements, if made by a student, indicates further instruction is needed?

A. "The nurse should never administer IV medications through tubing that is infusing blood, blood products, or parenteral nutrition solutions."
B. "The six rights of medication administration include the right medication, the right dose, the right patient, the right route, the right time, and the right documentation."
C. "If the IV bolus medication is incompatible with the IV fluids, another IV site will have to be started."
D. "The administration of hyperosmolar drugs by the intravenous route increases the risk of phlebitis."

Answer 1

The incorrect statement indicating the need for further instruction is the claim that IV medications should never be administered through tubing that is infusing blood, blood products, or parenteral nutrition solutions, as there are protocols that allow for it. The oral route is often convenient for home administration of antimicrobials, while intravenous administration ensures higher plasma concentrations quickly. Intravenous chemotherapy failure may be due to a catheter-related infection, making oral antibiotics more successful upon catheter removal.

Step-by-step explanation:

The statement that indicates further instruction is needed is: "The nurse should never administer IV medications through tubing that is infusing blood, blood products, or parenteral nutrition solutions." This statement is incorrect because there are situations in which IV medications can be safely administered through the same tubing as blood, blood products, or parenteral nutrition solutions, provided appropriate protocols are followed to prevent interactions and ensure patient safety. For example, certain medications may need to be paused or the line flushed before and after medication administration to ensure that no adverse reactions or incompatibilities occur. Nurses must be well-versed in their facility's policies regarding such practices.

When it comes to choosing the appropriate route of administration for an antimicrobial to treat a systemic infection, the oral route can often be convenient, especially for home administration. However, parenteral routes, such as intravenous or intramuscular injections, are preferred when the drug is not well absorbed in the gastrointestinal (GI) tract, or when a rapid and high plasma concentration of the drug is desired, as illustrated in Figure 14.7 where the plasma concentration of a drug administered intravenously peaks quickly.

Regarding the critical thinking scenario provided, intravenous chemotherapy may have failed to completely cure the patient due to a possible catheter-related bloodstream infection. The removal of the intravenous catheter and switch to oral antibiotics in the second round of antibiotic therapy might have been more successful for several reasons, such as the removal of the potential source of infection (the IV cathenter), better patient compliance, or altered pharmacokinetics and dynamics associated with oral administration.

Answer 2

The statement that indicates further instruction is needed is option C: "If the IV bolus medication is incompatible with the IV fluids, another IV site will have to be started." When administering IV medications, it is important to ensure compatibility between the medication and the IV fluids. If a medication is incompatible with the IV fluids, it should not be administered through the same IV site, as it can result in adverse reactions or reduce the effectiveness of the medication. Instead, another IV site should be started.

Step-by-step explanation:

The statement that indicates further instruction is needed is option C: "If the IV bolus medication is incompatible with the IV fluids, another IV site will have to be started."

When administering IV medications, it is important to ensure compatibility between the medication and the IV fluids. If a medication is incompatible with the IV fluids, it should not be administered through the same IV site, as it can result in adverse reactions or reduce the effectiveness of the medication. Instead, another IV site should be started.