The health care provider has ordered 5 mg of intravenous diazepam ...

[Themember4]

The health care provider has ordered 5 mg of intravenous diazepam (Valium) to treat the patient in status epilepticus. The patient's IV bag is labeled 1,000 mL D5NS with 20,000 units Heparin.
 
  . What nursing interventions are necessary to safely administer this diazepam (Valium)?
  1. Use a large bore needle to access the IV port.
  2. Flush the intravenous (IV) line with saline.
  3. Administer the diazepam (Valium) directly into a vein in the patient's hand.
  4. Dilute the diazepam (Valium) with xylocaine prior to administration.
  5. Observe the IV tubing for cloudiness while administering the diazepam (Valium).

Question 2

A low-income patient without insurance has been prescribed several different medications over several months for seizure control without any improvement. The patient indicates she has not experienced any adverse effects. At this point the nurse should
 
  1. recommend nontypical drug use.
  2. inform the patient that it might take years for the medications to work.
  3. assess for medication compliance.
  4. advise the patient to double the current dose.

[IAPPLET]

Answer to Question 1

Correct Answer: 2,5
Rationale 1: There is no need to use a large bore needle. Most IV administration is done using a needleless system.
Rationale 2: The IV line should be well flushed with saline to remove any residual heparin, which will precipitate with the diazepam (Valium).
Rationale 3: Direct administration of IV medication is not recommended. The patient receiving IV diazepam (Valium) should have an IV established for possible emergency use.
Rationale 4: Diazepam (Valium) precipitates with many drugs and should not be mixed for infusion.
Rationale 5: Diazepam (Valium) precipitates with many drugs. The nurse should watch the IV tubing just above the injection site for cloudiness or development of precipitate during administration and should discontinue the administration if this situation occurs.

Answer to Question 2

Correct Answer: 3
Rationale: Due to the financial situation presented and absence of any side effects, it is possible the patient is not in compliance. The nurse should assess for this possibility at this point. Another drug might be indicated, but compliance should be assessed first. It generally doesn't take years for seizure medications to work. Changing the prescribed dose of a medication is not within the scope of practice of the nurse.

[Themember4]

TYSM

[raenoj]

Excellent