The nurse encounters an IV setup issue at a patient's home because RPNs are not allowed to start IVs. What is the appropriate action?

• A. Administer IV meds per plan
• B. Call the nurse supervisor for guidance
• C. Call the doctor for instructions on next steps
• D. Document the event and await orders

Answer: (C)

Starting an IV and giving IV medications require explicit orders within a clinician’s scope of practice. When you hit an IV setup issue and you’re not authorized to start IVs, the safest, appropriate move is to obtain guidance from a physician to get clear instructions or an order on how to proceed. This ensures the plan aligns with medical direction and keeps the patient safe. While notifying a supervisor for escalation can be part of the process, the physician’s instructions are what authorize any next steps with IV therapy. Simply documenting the event or waiting without orders cannot substitute for that authorization, and administering IV meds without a proper order would be unsafe.