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Administering Intravenous MedicationsOnset and absorption Dosing and scheduling considerations Equipment Sites: Figures (adult) and (children) Intravenous infusion Starting an IV will be discussed in phlebotomy Can you identify an advantage of IV medication administration over IM administration as it relates to dosing? If you were preparing to insert an IV into an adult patient, which site would you look at first? What should the nurse do if he or she notes the solution to be hazy before administering it? At what angle to the patient’s skin should the nurse place the IV needle before insertion? Administering Intravenous Medications Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Intravenous sites in adultsCopyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Modifications in Technique for Specific SituationsAdding medication by piggyback infusion Administration of medication when there is only an intermittent infusion device Why is it important for the nurse to withdraw blood in the tubing when adding medication by syringe to an existing infusion? Why is it preferred that the nurse slowly add medications to a plastic bag or an IV bottle? The nurse applies a label to the volume control chamber after adding medication to it. The label should include the date, time, dosage, and medication added and be signed with initials. Can you think of a clinical condition when an intermittent infusion device would be beneficial? What drugs or solutions may be used to flush the patient’s tubing when an intermittent fusion device is used? Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Intravenous Infusion RatesMonitoring infusion rates Calculating infusion rates Infusion pumps; syringe infusion pumps Infusion controllers and volumetric pumps Implantable pumps Venous access device Common problems with intravenous infusions How often should the nurse check the patient’s infusion? Would you expect the drug dosage for the epidural route to be larger or smaller than the IV route? If the nurse determines the IV infusion has fallen behind, what should be done? Signs of an IV infiltrating include redness, swelling of the area, and pain. Is an order required for the LPN/LVN to discontinue an IV when it has infiltrated? Intravenous Infusion Rates Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
IV Piggy Back (IVPB) MedsThe LPN scope of practice allows for administration of antibiotics via IVPB using peripheral veins. The LPN can become IV certified after they graduate by taking a class to do so. The LPN is responsible for knowing the drug and its potential side effects. IV Piggy Back (IVPB) Meds Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Background Knowledge The LPN must know the name, class and action of the drug. What diluent is the medication compatible with? What is the rate and length of time for the infusion? How do you program the pump? What are the nursing parameters for giving the medication? What are the potential side effects? Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
IVPB medication – check patient name, medication name, and rest of the six rights.Clamp the tubing; remove the cover from the spike; pull off the port cover from the IVPB bag. Enter the bag’s port with the tubing’s spike. Flush medication through the secondary tubing using sterile technique. In the medication room Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
At the bedside 6 checks again. Assess the IV site; inflammation?Assess the hanging IV fluid; correct? Hang up the IVPB on the pole Lower the main IV bag 6-12 inches than the IVPB bag Cleanse the port with alcohol wipe for 30 seconds. Pierce the port with the sterile ‘needle’ from the secondary tubing set At the bedside Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Continued Set the IVPB infusion rate in the IV pump.Open the IV clamp on the IVPB tubing Monitor for IV dripping into chamber on tubing Assess the IV site again Plan your time to return to the patient room before the end of the infusion. After infusion; return Main IV to use. Dispose of waste properly. Continued Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Practice Use small IV bag as IVPB medicationFollow steps from slide 8 through 10. Ensure you have all equipment needed before you leave the medication room. Practice timing the drip in the chamber for the IV drip rate Practice Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Intermittent IVPB Assess the IV siteClean IV cap with alcohol swab for 30 seconds. Flush IV site with 5 mL sterile normal saline Swab; Attach IVPB tubing and set rate. Begin infusion; monitor IV site for inflammation & patient for reaction to med At end, flush IV site with 5 mL Sterile NS Intermittent IVPB Copyright © 2013, 2010, 2006, 2003, 2000, 1995, 1991 by Mosby, an imprint of Elsevier Inc.
Preparing and Administering Medications
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