Drug Compatibility Chart Problem- Please Help

BrandonM77 · Feb 9, 2013

Client #1 has a primary IV infusing CLK (a fake drug) 500mg in 1000ml of D5W @ 125/hr. It is time to pass 10am meds. The following medications are ordered for your clients at 10 am :

Client #1 – 1gram Drug X in 50 ml of D5W IVPB; infuse over 4 hours

500mg Drug Z in 100ml of D5W IVPB; infuse over 60 minutes

Collect the equipment you will need to give the 10am meds.

How will you determine which medication to administer first?

A critical assessment prior to hanging an IVPB is compatibility. Using the chart below is Drug X and Drug Z compatible with the primary infusion?

Explain the steps for hanging Drug X and Drug Z? Explain your answer.

MunoRN, RN · Feb 9, 2013

You're right, the chart is incorrect. You should get the same answer whether you check CLK against a drug using either the x axis or the y axis.

BrandonM77 · Feb 9, 2013

You're right, the chart is incorrect. You should get the same answer whether you check CLK against a drug using either the x axis or the y axis.

Thank you very much I have been beating my head around how to answer this problem correctly, this is hugely weighted against me. So the only correct way you could give all three of these drugs at the same time would be though multiple lumens or multiple PIVs or a combination of the two, is that correct? I stated in my answer I would first contact pharmacy to confirm which path was correct, then I went into explaining what I would do if all were incompatible.

MunoRN, RN · Feb 9, 2013

I think you're on the right track to first talk to pharmacy. If neither drug is compatible with the primary fluid, then you'll need other lumens or other IVs to run them through. You should also check with pharmacy about the timing of the meds. If you have only one other lumen other than what the primary fluid is running through, and you can't Y-site the drugs into the primary fluid due to incompatibility, then you want to check with pharmacy about re-timing the two drugs so that they don't both have to run simultaneously, otherwise you'll need two additional lumens/IV's in addition to what the continuous fluids are running through if the two drugs are incompatible.

nurseprnRN, BSN, RN · Feb 11, 2013

Both drugs are compatible with D5W, and there is no second way to check that, as D5W only appears on one axis. Drugs X and Z are noted as incompatible with each other on both axes. The X and Z compatibilities with CLK are not the same, so that needs to be checked c the pharmacist before you proceed.

Esme12, ASN, BSN, RN · Feb 12, 2013

Client #1 has a primary IV infusing CLK (a fake drug) 500mg in 1000ml of D5W @ 125/hr.It is time to pass 10am meds.

The following medications are ordered for your clients at 10 am :

Client #1 –
1) 1gram Drug X in 50 ml of D5W IVPB; infuse over 4 hours

2) 500mg Drug Z in 100ml of D5W IVPB; infuse over 60 minutes

Collect the equipment you will need to give the 10am meds.
A critical assessment prior to hanging an IVPB is compatibility.

How will you determine which medication to administer first?

1) Using the chart below is Drug X and Drug Z compatible with the primary infusion?

2) Explain the steps for hanging Drug X and Drug Z? Explain your answer.

Maybe I am crazy........

You have an IVF (CLK) infusing continuous. One of your intermittent IV drugs in NOT compatible with the main IVF ..........so it doesn't matter if IVPB drugs can be given together.

Drug X (to infuse over 4 hours) is compatible with the continuous IVF (CLK).

Drug Z is NOT compatible with the main IVF (CLK).

Hang Drug X piggybacked below the pump on the mainline CLK on it's own infusion pump for they are compatible.

Drug Z (to infuse over 60mins) that is not compatible with the continuous IVF (CLK) so you just collect the equipment necessary to start another line to give drug Z via heploc.

OR.......

Since Drug Z in only over 1 hour and you have 1 hour "leeway" to give meds. Cal the MD and get the OK to stop IVK (CLK) for 1 hour....flush IV, give Drug Z, then flush again and restart IVF (CLK) and give Drug X below the pump of IVF CLK, on it's own pump.

and the chart is wrong