A provider has ordered intravenous promethazine (Phenergan) for an adult patient postoperatively to prevent nausea and vomiting (N/V). What will the nurse do?
a. Administer the drug at a rate of 25 mg/min or more to achieve maximum effects.
b. Contact the provider to suggest using dimenhydrinate (Dramamine) instead.
c. Ensure that the IV is infusing freely through a large-bore needle.
d. Monitor the patient closely for cardiac dysrhythmias.
ANS: C
Promethazine can cause severe local tissue injury if it extravasates into tissues, so the medication should be administered in an IV that is flowing freely through a large-bore needle. The drug should be administered at a rate of 25 mg/min or less. Dimenhydrinate is indicated for motion sickness, not postoperative N/V. Cardiac dysrhythmias were a concern with two antihistamines no longer on the market, astemizole and terfenadine.
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