The nurse is preparing to administer total parenteral nutrition (TPN) with lipids to a client for the first time. The nurse reviews the client's medication orders and notes that which medications pose a risk for a drug interaction?
Standard Text: Select all that apply.
1. Insulin
2. Ranitidine
3. Ampicillin
4. Warfarin
5. Kanamycin
Correct Answer: 3,4,5
Rationale 1: Insulin is routinely mixed with TPN and does not pose a risk of a drug interaction.
Rationale 2: Ranitidine is routinely mixed with TPN and does not pose a risk of a drug interaction.
Rationale 3: Ampicillin is physically incompatible with TPN.
Rationale 4: TPN with lipids may decrease the therapeutic effect of warfarin.
Rationale 5: TPN with lipids may decrease the therapeutic effect of kanamycin.
Global Rationale: Ampicillin is physically incompatible with TPN. TPN with lipids may decrease the therapeutic effect of warfarin and kanamycin. Insulin is routinely mixed with TPN and does not pose a risk of a drug interaction. Ranitidine is routinely mixed with TPN and does not pose a risk of a drug interaction.
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