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A young man hospitalized for uncontrolled diabetes developed cardiac dysrhythmias. His doctor ordered a lidocaine (lignocaine) drip: 2 grams in 500 m1 of 0.9% sodium chloride for injection. The nurse quickly obtained a premixed solution containing the correct concentration of lidocaine and hung it for the patient. Unfortunately, she didn't read the label closely. If she had, she would have seen that the lidocaine was diluted not in sodium chloride but in 5% dextrose for injection. The patient was spared a possible hyperglycemic episode because another nurse stopped the infusion when she realized what it contained.
Premixed intravenous solutions are available for many commonly used drugs, including heparin, cimetidine, and numerous antibiotics. These solutions save nursing time and can help prevent medication errors because the proper dose of the correct drug has already been added. But using them doesn't eliminate the need to give all labels a careful reading.
Don't repeat this nurse's mistake. When obtaining a premixed solution, compare both the drug and diluent listed on the label with the doctor's order. When it comes to administering medications in this form, the right diluent is just as important as the right drug.