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Pharmacological and Parenteral Therapies

A nurse is preparing to administer a continuous IV infusion of norepinephrine 8 mg in 250 mL D5W at 12 mcg/min to a 68-year-old client in the ICU. The smart pump is programmed with the standardized concentration library. Which three actions should the nurse take before starting the infusion?

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Explanation
Before starting a high-alert IV medication such as norepinephrine, the nurse must perform independent safety checks. Verifying the infusion rate with a second nurse using the pump library ensures the dose matches the order and the standardized concentration, reducing programming errors. Tracing the IV line from the bag to the patient’s access site confirms the correct medication and route, preventing misconnections. Confirming the client’s identity with two identifiers is a standard safety practice to ensure the right patient receives the medication. Bypassing a smart-pump alert without clinical review is unsafe and violates safety protocols. Calculating a manual drip rate is unnecessary when using a smart pump with a library and may introduce error. Checking serum potassium is not directly related to norepinephrine administration safety. Obtaining baseline vital signs is important for monitoring but is not a pre-administration safety check for the infusion setup. Priming the tubing with the medication directly risks accidental exposure and is not a recommended safety step.
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For study reference only. Always follow current clinical guidelines and your institution’s protocols.