# 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?

> source: MyMerci (mymerci.kr)  
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> language: en  
> subject: Pharmacological and Parenteral Therapies  
> category: PPT

## Question

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?

1Verify the infusion rate with a second nurse using the pump library.
2Trace the IV line from the bag to the patient’s access site.
3Confirm the client’s identity using two identifiers per facility policy.
4Bypass the smart-pump alert if the dose limit warning appears.
5Calculate the manual drip rate as a backup to the pump.
6Check the client’s most recent serum potassium level.
7Obtain a baseline blood pressure and heart rate reading.
8Prime the tubing with the norepinephrine solution directly.

## 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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