If a nurse observes fat globules floating in the bottle of fat emulsion meant for parenteral nutrition, what should the nurse do?

When a nurse observes fat globules floating in a bottle of fat emulsion intended for parenteral nutrition, the most appropriate action is to request a new bottle from the pharmacy. This is crucial because the presence of fat globules may indicate that the emulsion has broken down or is not properly mixed, potentially compromising the safety and efficacy of the fat emulsion.

Fat emulsions are formulated to be stable and homogeneous, allowing for even distribution of fat particles throughout the solution. If fat globules are visible, it suggests that the emulsion may have separated, which can lead to complications when administered intravenously. Administering an unstable emulsion could increase the risk of embolism or adverse reactions in patients.

Shaking the bottle to mix the solution is inadequate because it might not resolve the underlying issue of separation and could even enhance the risk of air embolism while mixing. Similarly, using the emulsion despite its appearance poses significant health risks. Warming the bottle before use is not a recommended practice as it does not address the fundamental problem of the emulsion's instability.

Therefore, requesting a new bottle ensures that the patient receives a safe and effective product that meets the necessary quality standards.