Prevent inactivation of gentamicin by avoiding mixing with imipenem in the same IV bag

A nurse working in the neurointensive care unit is caring for a patient with a head injury who has been experiencing seizures and now has pneumonia caused by Pseudomonas aeruginosa. The physician has prescribed imipenem 1 g IV every 6 hours plus gentamicin for the pneumonia. Before administering the antibiotics, the nurse should do which of the following? A. Avoid mixing the imipenem and gentamicin in the same IV bag to prevent inactivation of the gentamicin. B. Remind the physician of the patient’s seizures and inquire whether a different antibiotic might be safer. C. Suggest to the physician that imipenem is used to treat gram-positive infections and will not be effective in this patient. D. Set the infusion pump to deliver the imipenem over 15 minutes

B

A. Avoid mixing the imipenem and gentamicin in the same IV bag to prevent inactivation of the gentamicin.

The correct answer is A. Imipenem and gentamicin should not be mixed in the same IV bag, as imipenem can inactivate the gentamicin. It is important to administer both antibiotics separately, with a separate IV line or port. Reminding the physician of the patient’s seizures and inquiring about safer alternative antibiotics (Option B) is important, but it is not the first priority in this situation. Imipenem is a broad-spectrum antibiotic that can be effective against many types of bacteria, including Pseudomonas aeruginosa (Option C is incorrect). It is also important to set the infusion pump to deliver the imipenem over the appropriate amount of time (Option D), but this is not the first priority in this situation.

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