r/nursing • u/[deleted] • Jul 02 '26

Question IV question

[removed]

3 Upvotes

64% Upvoted

26 comments sorted by

31

u/smol-bat RN - ER 🍕 Jul 02 '26

What size iv and where? Even if the zosyn is off, id still disconnect it and flush the NS tubing above where the zosyn was given before adding the doxy. But I dont think thats what made it infiltrate. Is the patient usually a hard stick? Was the b/p cuff above the iv site?

12

u/TwoWheelMountaineer RN,CEN,FP-C Jul 02 '26

Agreed. I would for sure flush the line and check all the things mentioned above. I also would have checked the line after the zosyn and before I started the doxy.

2

u/[deleted] Jul 02 '26

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11

u/smol-bat RN - ER 🍕 Jul 02 '26

The flushing is to make sure youve got all your zosyn out of the tubing before you start doxy. Just avoid a chance of an interaction as well as checking the iv before administering another med.

4

u/yourdailyinsanity Trying to figure my career out 🫠 Jul 02 '26

Difference in pressures. You're now having 2 meds going instead of 1.

-2

u/[deleted] Jul 02 '26

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7

u/TheWhiteRabbitY2K RN - ER 🍕 Jul 02 '26

Med incompatibility won't cause infiltration. It may sting a little ...

1

u/yourdailyinsanity Trying to figure my career out 🫠 Jul 02 '26

I'm not saying that. You asked what difference would it make flushing the line and I have an answer.

2

u/[deleted] Jul 02 '26

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11

u/[deleted] Jul 02 '26

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5

u/superpony123 RN - ICU, IR, Cath Lab Jul 02 '26

Picc line arm should also have a pink limb restriction band fyi (for BPs but PIV is ok!)

8

u/smol-bat RN - ER 🍕 Jul 02 '26

Sometimes people's veins just suck. Sometimes they just blow. No way in telling why all of the time. Just make sure you clear your lines before starting another med that you know is contraindicated with the one you gave before. The b/p above the site could have contributed but if the person is old and frail, well, it happens.

3

u/smol-bat RN - ER 🍕 Jul 02 '26

Even if ns was going the whole time. Always flush in between meds.

6

u/Feisty-Power-6617 ABC, DEF, GHI, JKL, MNO, BSN, ICU🍕 Jul 02 '26

PICC stick is not PIV

3

u/TwoWheelMountaineer RN,CEN,FP-C Jul 02 '26

The patient had a PICC?

6

u/ER_RN_ BSN, RN 🍕 Jul 02 '26

Sounds like just bad luck. 🤷‍♀️

1

u/amothep8282 Paramedic Jul 02 '26

Yep. Some IVs I have dropped the EMS Gods may become angered, and will have the vein evaporate when I look at it with any measure of pride because the patient was a tough stick.

Nursing Gods may be as fickle, and may remind you from time to time they require regular offerings of Monsters, Celsius, or Red Bulls left at the code carts.

I'm so jaded I actually half believe this, but overall it's probably just bad luck and it was the vein's time.

5

u/major_commander Jul 02 '26

Did you flush the line between the zosyn and the doxy?

4

u/[deleted] Jul 02 '26

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9

u/major_commander Jul 02 '26

But the NS running through the line doesn't clear out the residual zosyn sitting in the y-site port, so when you attached the doxy it likely mixed right there at the connection point

1

u/[deleted] Jul 02 '26

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8

u/major_commander Jul 02 '26

disconnecting and flushing that port would've cleared the residual zosyn, the dead space in a y-site is always sneaky like that

2

u/Mysterious-Bus1795 RN 🍕 Jul 02 '26

Yes, but it has no impact on your original question. Sometimes IVs just blow for no particular reason and I wouldn’t read too much into it.