PICC PICC Pharmacology & Medication Administration 2 — Questions and Answers
Question 1: A patient receiving lipid emulsion via PICC develops fever, chills, and back pain shortly after starting the infusion. The nurse should first suspect:
- Catheter-related bloodstream infection
- Hypersensitivity or infusion reaction to lipid emulsion (Correct answer)
- Air embolism
- Phlebitis
Correct answer: Hypersensitivity or infusion reaction to lipid emulsion
Acute fever, chills, and back pain during lipid emulsion infusion are classic signs of a hypersensitivity or infusion reaction, requiring immediate infusion cessation and provider notification.
Question 2: What is the maximum hang time for lipid-containing parenteral nutrition (3-in-1 admixture) administered via a PICC per INS guidelines?
- 12 hours
- 24 hours (Correct answer)
- 48 hours
- 72 hours
Correct answer: 24 hours
Per INS guidelines, 3-in-1 TPN admixtures containing lipids should be infused within 24 hours of compounding to prevent lipid destabilization and microbial growth.
Question 3: Which filter size is required when administering lipid emulsions through a PICC to prevent particulate matter from reaching the patient?
- 0.22-micron filter
- 0.45-micron filter
- 1.2-micron filter (Correct answer)
- 5-micron filter
Correct answer: 1.2-micron filter
A 1.2-micron filter is required for lipid-containing solutions because the smaller 0.22-micron filter would remove the lipid particles from the emulsion.
Question 4: A nurse is administering vancomycin via PICC and the patient develops flushing, erythema of the neck, and hypotension. This presentation is consistent with:
- Anaphylaxis requiring epinephrine
- Red man syndrome due to rapid infusion rate (Correct answer)
- Catheter-related bloodstream infection
- Infiltration of vancomycin into surrounding tissue
Correct answer: Red man syndrome due to rapid infusion rate
Red man syndrome is a non-allergic infusion reaction to vancomycin characterized by flushing, erythema, and hypotension that typically resolves by slowing the infusion rate.
Question 5: When co-administering two IV antibiotics through a dual-lumen PICC simultaneously, what is the most important nursing action?
- Use the same lumen for both to ensure mixing
- Verify compatibility of both antibiotics before simultaneous administration (Correct answer)
- Flush only after both medications are completed
- Increase flow rate to minimize contact time between drugs
Correct answer: Verify compatibility of both antibiotics before simultaneous administration
Before simultaneous infusion through a multilumen PICC, the nurse must verify drug-drug compatibility to prevent precipitation, inactivation, or patient harm.
Question 6: Which electrolyte additive in IV solutions via PICC requires a nurse to use a filter and careful infusion rate monitoring due to its cardiac toxicity potential?
- Sodium chloride
- Potassium chloride (Correct answer)
- Magnesium sulfate
- Calcium gluconate
Correct answer: Potassium chloride
Potassium chloride is cardiotoxic if infused too rapidly and requires careful rate monitoring; standard practice mandates maximum infusion rates and concentration limits via central access.
PICC PICC Pharmacology & Medication Administration 2
A patient receiving lipid emulsion via PICC develops fever, chills, and back pain shortly after starting the infusion.
The nurse should first suspect: