IV Therapy Part 2

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Questions and Answers

What is a key principle to follow when administering IV push medications?

Determine the compatibility of the medication with the existing IV solution. (correct)

Use the largest gauge needle available for infusion.

Shake the syringe to mix the medication before administration.

Administer the medication rapidly to ensure quick action.

Which of the following is a primary concern when managing a saline lock?

Using a saline lock that has not been labeled.

Regularly inspecting for signs of infection or phlebitis. (correct)

Flushing the lock with excessive saline to maximize patency.

Ensuring that the lock remains visible and easy to access.

When using an infusion pump, which operation is critical to ensure safe delivery of IV fluids?

Setting the flow rate without confirming the physician's order.

Checking the battery life of the pump only once daily.

Hanging the IV bag above the pump without considering gravity.

Regularly assessing the site for signs of infiltration. (correct)

What should be done if complications occur during IV therapy?

Immediately notify the physician and discontinue the IV. Signup and view all the answers

Which of the following is NOT a part of the medication administration protocols for IV therapy?

Adding medications without checking the primary IV solution. Signup and view all the answers

What is the purpose of cleansing the port before adding medication to an IV bag?

To prevent contamination Signup and view all the answers

Which step is essential when preparing a medication for an IV push via a primary IV line?

Determine the compatibility of the medication with existing IV solutions Signup and view all the answers

When administering medication through a saline lock, what is the primary concern during the procedure?

Ensure venous access is intact Signup and view all the answers

What is the correct sequence of actions after preparing the medication and attaching the syringe to the port for an IV push?

Pinch, inject, and release while monitoring the infusion Signup and view all the answers

What information must be included when labeling a syringe prepared for IV medication administration?

Name of medication, dosage, and your initials Signup and view all the answers

What are the potential consequences of administering a medication too quickly through an IV push?

Serious adverse reactions or complications Signup and view all the answers

Which factor is NOT necessary to confirm before administering medication through a saline lock?

The patient's last meal Signup and view all the answers

What is the correct definition of IV push in medication administration?

Introducing a concentrated dose of drug directly into the systemic circulation Signup and view all the answers

What should be done after injecting medication into a primary IV line?

Observe for reactions and document the administration Signup and view all the answers

What is the purpose of flushing the saline lock before medication administration?

To ensure patency of IV access Signup and view all the answers

Which of the following is an advantage of using electronic infusion pumps compared to gravity flow?

Offers alarms to notify of problems during infusion Signup and view all the answers

What is the correct rate to program an infusion pump if a healthcare provider orders an infusion of 1000 mL of 0.9% NaCl at 100 mL/hr?

100 mL/hr Signup and view all the answers

Which of the following symptoms might indicate localized complications from IV therapy?

Redness and swelling at the site Signup and view all the answers

What is the procedure to follow after completing an IV push with saline lock?

Flush with saline and document the administration Signup and view all the answers

In case of suspected catheter occlusion, what immediate action should be taken?

Verify the rate and check for obstructions Signup and view all the answers

What safety measure is essential when administering IV medications via saline lock?

Administer flush and medication at a slow, steady rate Signup and view all the answers

Which is not a recommended step when discontinuing an IV?

Remove IV tubing without closing the roller clamp Signup and view all the answers

Study Notes

IV Therapy: Part Two

Topics covered include administration of IV push medications, complications of IV therapy, and infusion pumps.

IV Therapy: Part 2 Unit Outcomes

Examine principles of safe preparation, administration, and documentation of intravenous therapy, including:
- Adding medication to primary IV solution
- IV push medications
- Discontinuing IV
Demonstrate ability to prepare and administer IV medications via IV push method.
Identify complications of IV therapy
Explain principles of infusion pumps

Review of IV Therapy - Part 1

Review the following for primary and secondary bags:
- IV access patency (without complications)
- Bag solution (volume, label, expiration date)
- Tubing type, length, and label
- Flow rate (drops/min or mL/hr)
- Compatibility of secondary solution with primary solution
- Documentation on MAR, I/O sheet, and narrative notes (if applicable)

Intake and Output Example

Patient is post-op day 1 from abdominal surgery.
Currently NPO and receiving 0.9% NS at 100 mL/hr.
Oncoming nurse checked the IV bag at 0700 and it contained 500 mL.
At 1200, a new 1000 mL bag was hung.
At 1500, 700 mL remained in the IV bag.
Requires correct intake and output record documentation.

Adding Medication to an IV Bag

Added by Pharmacy personnel.
Necessary in emergency situations, when Pharmacy staff unavailable, or in remote locations.
Preparation steps include:
- Checking medication order and venous access site
- Identifying allergies and medication availability
- Collecting compatibility information and infusion timing
- Calculating dosage and preparing the medication in a syringe

Adding Medications to IV Bag

Cleanse the port.
Inject the medication and gently mix.
Immediately add a label including:
- Medication name
- Dosage
- Infusion rate
- Date and time of administration
- Nurse's initials

Medications Administration: IV Push

Definition: introducing a concentrated dose of drug into systemic circulation via IV access.
Methods include:
- Injection port of primary IV tubing
- Saline lock (capped angiocatheter).
Potential serious consequences if not administered correctly.

Medication Administration: IV Push Focused Assessment

Steps include review of health care provider's order and noting any medication allergies and diagnoses. -Also includes assessment of primary IV line patency, IV line conditions, IV solution information and infusion.

Medication Push via a Primary IV Line

Understanding medication information is crucial.
Some medications require dilution prior to administration.
Determine the required injection time.
Check compatibility with existing IV solution and additives.
Prepare and label the syringe correctly.

Medication Administration: IV Push via a Primary IV Line (Procedure)

Prepare medication as indicated and label the syringe with name, dose and initials.
Perform hand hygiene and apply non-sterile gloves.
Cleanse the injection port for 15 seconds.
Attach the syringe to the port closest to the patient.
Administer "Pinch, Inject, Release" (P-I-R) over a specified time.
Continue to pinch the primary IV tubing while injecting.
Remove the syringe when the medication is infused.

Medication Administration: IV Push via a Primary IV Line (Post-Procedure)

After injecting, recheck IV fluid infusion rate.
Observe for medication reactions.
Document the procedure.
Reassess the patient within 30 minutes.

Medication Administration: IV Push via Saline Lock

Prepare 2 syringes of flush solution, labeled.
Use 1-5 mL saline flush (per agency policy) or pre-filled saline syringes.
Flush before and after medication infusion.
Ensure IV access patency before administering medication into the "lock."
Flush the extension tubing with saline after medication administration.
Determine the time needed for medication infusion.

Medication Administration: IV Push via Saline Lock (Extension set)

Extension set with an injection port.

Medication Administration: IV Push via Saline Lock (Procedure)

Have three syringes ready:
- One with medication and two for flushing.
Ensure the medication syringes are labeled.
Use clean alcohol pads for sanitizing.
Clean equipment for IV infusion prior to medication administration.
Administer IV flush solution and medication as prescribed at a slow, steady rate and observe the insertion site.
Administer the medication as prescribed at the correct rate once the flush is successfully completed.

Infusion Pumps/Electronic Devices

Mechanical pressure infuses fluid into veins.
Accurate volume delivery over set time (mL/hr).
Advantages over gravity flow include actively pumped fluid, adjustable primary and secondary rates, and alarms for issues.
Infusion pumps have libraries of standardized concentrations of common drugs.
Dose error reduction systems (DERS) provide immediate feedback of infusion issues.

Infusion Pumps/Electronic Devices: Rate Calculation

Example: HCP Order for 1000ml 0.9% NaCL at 100mL/hr calculation.
The pump will be programmed to 100 mL/hr as this is the only unit the pump understands.

Infusion Pumps/IV Pumps: Nursing Responsibilities

Responsibility remains the same whether infusions occur by gravity or infusion pumps.
Ensure the ordered IV solution is hanging.
Monitor the patient regularly to ensure safe infusion of fluids, the catheter insertion site for patency, and for other complications.

Complications of IV Therapy: Loss of Patency/Catheter Occlusion

Addressing bubbles in tubing: close roller clamp below bubbles and tap tubing.
Addressing drip chamber full: close slide clamp, invert, squeeze.
Adjusting rate (too fast or too slow): adjust roller clamp and note IV bag height.
Obstruction identification: look for any issues preventing flow.

IV Therapy Complications: Other Complications

Local complications include infiltration, phlebitis, cellulitis/infection, severed catheter and hematoma.
Older adults are at greater risk of phlebitis.

IV Therapy Complications: Systemic Complications

Potential systemic complications include septicemia, air embolism, circulatory overload, and allergic reactions.
Older adults are at risk due to age-related changes in cardiovascular and kidney function; existing heart and kidney disease can exacerbate this.

IV Therapy: Discontinuation

Gather equipment: sterile 2x2 gauze, clean gloves, and tape.
Apply clean gloves.
Close roller clamp and remove IV tubing from extension tubing.
Remove IV site dressing.
Withdraw the catheter from the vein and observe that the catheter is intact.
Assess the IV site for redness, swelling, or drainage.
Apply continuous pressure to the site for 2-3 minutes.
Secure the sterile dressing in place with tape.

IV Dressing Change

Peripheral IV dressing changes are required when a catheter is changed or replaced, every 96 hours.
The dressing should be changed if it becomes damp, loose or soiled.,

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Description

This quiz focuses on advanced principles of intravenous (IV) therapy, covering the administration of IV push medications, potential complications, and the use of infusion pumps. Participants will also review essential preparation, documentation, and the necessary safety measures. It's essential for healthcare professionals to be well-versed in these topics for effective patient care.