NCLEX · General

A nurse is preparing to administer an unfamiliar IV medication. The pharmacy has provided the drug but the nurse is uncertain about the safe administration rate. What is the correct action?

Correct answer

Look up the drug in a nursing drug reference or call the pharmacy to confirm the safe infusion rate before administration — never administer an IV medication at an unknown rate; incorrect IV push rates are a leading cause of preventable adverse events

  1. A Administer it at any rate since it came from the pharmacy
  2. B Look up the drug in a nursing drug reference or call the pharmacy to confirm the safe infusion rate before administration — never administer an IV medication at an unknown rate; incorrect IV push rates are a leading cause of preventable adverse events
  3. C Ask a colleague to guess the rate
  4. D Administer it slowly just to be safe

Why this is the answer

SAFE IV MEDICATION ADMINISTRATION: FOUR RIGHTS FOR IV MEDICATIONS: Right drug, right dose, right patient, right time PLUS right rate for IV medications; SAFE IV RATES: Critically important — many IV drugs must be administered over a specified time to prevent adverse effects; too fast = cardiac arrhythmias, hypotension, CNS toxicity; SPECIFIC EXAMPLES: Vancomycin: minimum 60 min for 1g (Red Man Syndrome if too fast); potassium IV: maximum 10-20 mEq/hr peripheral; IV calcium: slowly — cardiac arrest risk if rapid push; morphine IV push: typically over 4-5 minutes; furosemide IV: over 1-2 minutes; phenytoin: ≤50 mg/min; RESOURCES: Drug handbook (keep one at the bedside); clinical pharmacist (available by phone 24/7 in most hospitals); package insert; facility infusion guideline; NEVER: Guess; ask a non-pharmacist non-prescriber for dosing guidance; rely on memory alone for unfamiliar medications; PN SCOPE: Know your resources; it is SAFE PRACTICE to call pharmacy — not a sign of weakness.
Source: NCLEX-PN Safe Care — Medication Safety, Unknown IV Rate