Case Study Madison Wills worked night shift on a neonatal intensive care unit (NICU) at a major medical center. She assumed the care of a very sick premature infant that weighed 1 kilogram (a little over 2 pounds). Sylvia Smithson had been the infant’s nurse during the day shift. Sylvia had initiated the infant’s intravenous (IV) antibiotic infusion at 6:30 p.m., just before shift change. She reported that the infant’s IV line in his arm was patent and the IV site had no redness or swelling.
When Madison assessed the infant at 7:45 after the end-of-shift report, she noted that the baby’s arm was swollen and that the IV had infiltrated (was no longer in the vein). When she stopped the infusion, she also noted that the dose on the antibiotics was incorrect and was much too large for a very small infant.
Respond to these questions:
1. What is the first thing that Madison should do after discovering these two problems?
2. Which of these problems (the infiltration or the dosing) was the most significant?
3. What is the nurse’s responsibility when an antibiotic is prepared by the pharmacy?