Intravenous Medication IV Nursing Lecture

Objectives:

– Compare & contrast various types of equipment used for IV medications
– Identify the critical elements of:
– Adding an IV medication to an IV bottle or bag
– Adding an IV medication to a volume control administration set

– Correctly perform the procedures for preparing & adding IV medication to an IV bottle or volume control administration set
– Monitor the IV infusion to maintain the specified drip rate for the medication & IV fluid
– Explain how the client’s response and/ or adverse reaction would be monitored
– Practice recording appropriate information

IV Medication

– Appropriate when a rapid effect is required
– Appropriate when medications are too irritating to tissues in other routes

Potential Hazards for IV medications

– Infection                   sterile technique
– Rapid, severe reactions to the medications; drug should be administered slowly if unwanted reaction, discontinue immediately

 

Various Types of Equipment

– IV bottle
– IV bag
– Volume- Control set

Intervention

– Verify which infusion to receive medication
– Confirm the compatibility between medication & IV solution
– Maintain sterility of IV & medication
– Attach appropriate medication label to IV container

– When adding medications to infusing containers:
– Make sure there is sufficient solution to dilute the drug
– Clamp the IV tubing before adding medications
– Insert medications only through medication port
– If using air vent port, insert medication syringe without needle

Infusing bottle

– Make sure sufficient solution in bottle to ensure proper dilution of drug
– Close IV flows clamps to prevent medication from infusing to patient before it is properly diluted with solution
– Inject medication through medication port
– Clean medication port  with antiseptic, insert needle & inject medication

Plastic IV bag

– Clean medication port with antiseptic swab
– Support bag with thumb & forefingers
– Insert needle through port & inject medication
– Attach medication label to IV container
– Gently lift & rotate container
– Open IV flow clamp & regulate the rate as ordered

Plastic IV bag
Administrating IV Medications Using Volume Control Administrating Set

Purposes:
– To administer IV medications (antibiotics) that do not remain stable for the length of time it takes an entire solution container to infuse
– To administer medications intermittently

Volume Control Administrating Set

– To avoid mixing medications that are incompatible
– To dilute medication so that it is less irritating to veins than by given by IV push
– To deliver medications diluted in precise amount of fluid

Intervention

– Check physician’s order, compatibility of medication
– Prepare medication (ampule or vial)
– Insert the spike of the volume control set into the solution container, hang the container
Open the air vent clamp on volume control set

– Clamp the lower clamp below drip chamber
– Fill volume control & prime tubing, allow drip chamber to fill 30 ml then close the clamp
– Open the lower clamp & flatten the drip chamber, while that close the lower clamp; Fill it to half full
– Open lower clamp, prime tubing, close the clamp

Administer Medication

– Fill volume control with 50 to 100 ml fluid
– Close the inflow to the fluid chamber
– Clean the medication port on volume control fluid chamber with alcohol swab
– Inject medication
– Rotate fluid chamber till it’s mixed
– Open line’s upper clamp, regulate the flow by adjusting lower roller clamp

– Attach medication label to volume control fluid chamber
– Document (type, amount of solution, medication & dose added, & time of starting and completing the infusion
Critical Elements

– Check the compatibility of medication & IV solution
– Maintain sterility of IV & medication equipment
– Prime volume- control set
– Apply appropriate medication label

Before inserting the medication:
– Make sure there is sufficient solution in Volume- control set to dilute medication
– Close the inflow clamp
– Clean medication port

– Regulate the flow appropriately

 

– Stop IV if any adverse reaction noted & report immediately to physician
–    noisy respiration
–    change in pulse
–    chills
–    nausea
–    headache

 
– IV push (Bolus) is IV administration of undiluted drug directly into systemic circulation


– Used when medication cannot be diluted
– Used in emergency
– Can be administered directly into vein by:
– Venipuncture
– Into IV line or injection port or IV lock

 

Indications

– For emergency administration of cardiopulmonary resuscitative procedures, allowing rapid concentration of a medication in the patient’s blood stream
– When quicker response to the medication is required, eg, lasix, digoxin
– To administer “loading” doses of a drug that will be continued via infusion, eg, Xylocaine

– To reduce patient discomfort by limiting need for intramuscular injections
– To avoid incompatibility problems that may occur when several medications are mixed in one bottle
– To deliver drugs to patients unable to take them orally, eg, coma or intramuscularly, eg, coagulation disorder

Precautions & Recommendations for Intravenous Medication IV

Before administration of the medication:
a- Determine that the medication matches the order
b- Dilute the drug as indicated by pharmacy references. Many medications are irritating to veins & require sufficient dilution

c- Determine the correct (safest) rate of administration. Most medications are given slowly (rarely less than 1 min., as long as 30 mins. Too rapid administration may result in serious side effect
d- If IV push is to be given with an ongoing IV infusion or to follow another IV push medication, check for incompatibility. It is always recommended to flush the IV tubing or cannula with saline before & after administration of drug

 

e.    Assess patient’s condition & ability to tolerate the drug
f.    Assess patency of IV line by presence of blood return
–    lower running IV
–    withdraw with syringe before
injecting medication
–    pinch IV tubing gently

 

 

Watch patient’s reaction to the drug
– Are there major side effects, such as anaphylaxis, respiratory distress, tachycardia, bradycardia, or seizures
– Are there minor side effects such as nauses, flushing, skin rash, or confusion
– Stop medication & inform physician if any such reactions occur

Medication Calculation

Formula:

Desired dose X Quantitiy
——————————–
Dose on Hand

 

Example:

Order: Ampicillin 100 mg q6hr
Dose on hand: 250 mg in 2cc

100 mg    x 2cc
———-
250 mg                      = 0.8cc

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Posted in Critical Care Nursing, Nursing Care Plans, Nursing Intervention

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