Case Studies - Read & Test
Infusing Medication into Arterial Line
During hospitalization after cardiac surgery, a 16-year-old patient was administered intravenous promethazine for nausea and vomiting. An arterial line in the radial artery monitored the patient's blood pressure and blood gases. When the antecubital intravenous line infiltrated, the nurse paged a resident to restart the line so that the patient could receive a noontime dose. The resident arrived at the patient's room on his way to lunch. After several unsuccessful attempts to restart the line, the resident became frustrated and directed the nurse to infuse the promethazine into "the other line." .
Although the nurse was concerned that intra-arterial administration of promethazine might be improper, the nurse complied with the resident's order. Shortly after the infusion, blanching of the fingers was observed, followed by the hand. Despite multiple efforts to increase arterial blood perfusion, the patient's hand became swollen, pale and cold. Over the next several days, ascending necrosis occurred, requiring amputation of three fingers.
From your analysis of the case, assess whether the following statements are true or false:
Answer
-
A nurse has a duty to question a medication order
that is not within the standard of care for administration.
True or False -
A nurse should administer a medication order without
question because a physician's knowledge of medications
and their administration is more advanced than that
of a nurse.
True or False -
If a nurse follows the protocol for questioning a physician's
improper orders, the nurse should not receive disciplinary
action.
True or False
For answers to the quiz above, and a short discussion of the case, click here.