IVPB administration and potential problems

EmmaG, RN · Sep 25, 2007

The problem is that (with a single IV access) you can't give all three at the same time.

scrubing77 · Sep 25, 2007

It is easy. Ok say all 3 are do at 0800. You have one hour before till one hour after to give meds so here is what you do.

0700 give Cetriazone 1gm/50cc 30 min.

0730 give Cefazolin 1 gm/50cc 30 min.

0800 give Cipro 400 mg/200cc 60 min.

That way you have given all three with in the window. Also you will need to flush the line in between. Or i would i should say. Just to make sure you have cleaned the tubing and catheter out just in-case there would be any reaction to the different antibiotics. This is of course if you are only using one IV site.

EmmaG, RN · Sep 25, 2007

Some hospitals only give 1/2 hour before and after the time due; what we'd do is reschedule the daily doses to an hour earlier. Then give the others within the window. Not sure if I'd put that on a test though lol.

Christie RN2006 · Sep 25, 2007

:angryfireMultiple IVPB ordered for the same time
Cetriazone 1gm/50cc 30 min QD
Cefazolin 1 gm/50cc 30 min Q8hr
Cipro 400 mg/200cc 60 min Q12hr
Possible Solution?
I don't even see the problem and my teacher expects me to find a solution?
I have a test in 2 days and I am desperate, help!

Sounds like a typical patient in the surgical unit! I'm not sure what your prof is looking for, but I personally would either start an hour early like scrubing77 said or ask pharmacy to retime the doses to spread them out.

Just a little tid bit for ya... you always want to give antibiotics as close to the scheduled time as possible because they do the most good if there is a constant dose in the body. That is the reason why we do vanco peak, trough, and random levels. We draw those so that we can evaluate the amount of the medication in the blood stream at different times and can adjust the dose accordingly. If you gave medications at random times and never at the same time, how could you evaluate the levels accurately?

elthia · Sep 25, 2007

:angryfireMultiple IVPB ordered for the same time
Cetriazone 1gm/50cc 30 min QD
Cefazolin 1 gm/50cc 30 min Q8hr
Cipro 400 mg/200cc 60 min Q12hr
Possible Solution?
I don't even see the problem and my teacher expects me to find a solution?
I have a test in 2 days and I am desperate, help!

Start a second IV site and run 2 IVPB at the same time, so long as the pt isn't that brittle of a CHF pt, there's not really a chance of throwing someone into overload.

Christie RN2006 · Sep 25, 2007

Start a second IV site and run 2 IVPB at the same time, so long as the pt isn't that brittle of a CHF pt, there's not really a chance of throwing someone into overload.

That would work, but what if the patient started having a reaction? How would you know which antibiotic they were having a reaction to?

jojotoo, RN · Sep 25, 2007

All due at 0800:

0730: ceftriazone

0800: cefazolin

0830: cipro

I don't give more than one IVPB abx at once for the same reason that Christie mentioned: if the patient has a reaction, how do you tell which med is causing it?

sister--* · Sep 29, 2007

Okay, I'm interested in the test's answer to this question.

Perhaps just a bit of Devil's Advocate, too: I may not be looking at the correct resource, but, I'm not finding a Cetriazone. I see Ceftriaxone (Rocephin) listed. Maybe a need to clarify the medication?

elthia · Sep 29, 2007

That would work, but what if the patient started having a reaction? How would you know which antibiotic they were having a reaction to?

True.

However, pt's don't have an allergic reaction the FIRST time time they are administered an antibiotic, unless they are already allergic. That is why it is important to check for allergies before administering any med. An allergic reaction can show up hours later, or on the second or third dose, or even later. I have had pt's develop rashes from IV zosyn on day 3 or 4, and oral bactrim on day 3.

IngyRN · Sep 29, 2007

I would ask pharmacy to change times. That way its consistently given at the same time. The next nurse may not think to give it in that same order.

Daytonite, BSN, RN · Sep 29, 2007

0700 give Cetriazone 1gm/50cc 30 min.
0730 give Cefazolin 1 gm/50cc 30 min.
0800 give Cipro 400 mg/200cc 60 min.

Exactly what I would do.