NCLEX Practice Test

What is the best action for a nurse when there is a new prescription to begin amphotericin B IVPB during a client's blood transfusion through a double-lumen PICC line?

1. Administer amphotericin B through the unused lumen of the PICC line

2. Insert a peripheral IV line to begin infusion of amphotericin B

3. Interrupt the blood transfusion to infuse amphotericin B, then resume after infusion

4. Wait 1 hour after transfusion finishes before administering amphotericin B

The correct answer is: Administer amphotericin B through the unused lumen of the PICC line

When administering amphotericin B in conjunction with a blood transfusion through a double-lumen PICC line, the best action is to administer amphotericin B through the unused lumen of the PICC line. This approach is optimal because it allows for the concurrent administration of both therapies without interruption. Utilizing the unused lumen ensures that the medications do not mix, which is particularly important with amphotericin B, as it can be irritating to tissues and may interact adversely if it comes into contact with blood components or other medications. Additionally, this method maximizes the efficiency of treatment by maintaining the blood transfusion and the antibiotic therapy without delays that could occur if either were interrupted. Choosing to insert a peripheral IV line instead may not be necessary and could increase the risk of complications related to additional IV access. Interrupting the blood transfusion to infuse amphotericin B could lead to delays in therapy and potential reactions from the transfusion that could be avoided. Waiting an hour after the transfusion to administer the medication could also prolong the client's treatment unnecessarily and may not be clinically justified if there is an unused lumen available for use. Thus, utilizing the unused lumen of the PICC line is the most effective and safest action in this scenario.