Flashcards
Intravenous Administration
Cards in this deck (47)
- 1Name Some recommendations for the prevention of needle stick injuries (their are 7)?1. dispose of sharps with only one hand
2. use SESIP needle devices
3. No recap after med admin
4. Dispose SESIP in Sharps again one hand
5. maintain needle stick log
6. Receive HEP B vaccine, no path & prevent infection.
7. Help to select the SESIP needle to use. - 2Name the 3 methods nurses use to administer medications Intravenously?1. as mix within large volumes of IV fluids
2. Injecting bolus or small volume of IV fluids (meds) through an est. IV infusion line or intermittent venous access (heparin or saline lock).
3. "piggyback" infusion of a sol. containing prescribed med and small volume of IV fluid through an est. line. - 3In all 3 of the IV administration methods a patient will have what?1. An IV infusion running continuously
2. IV access site ready for intermittent fusions. - 4What does a policies and procedures list indicate regarding IV medications?1. who can give IV meds
2. Which patient care units can IV meds be given in.
3. what med, capability and avail. of staff, and type of monitoring equipment. - 5Name 3 reasons we use any method of IV administration?1. IV medication administration
2. IV fluid therapy for fluid replacement particularly if unable to take oral fluids.
3. IV fluid as a means of supplying electrolytes and nutrients. - 6What are the 11 laws of IV med administration?1. observe patient closely for SE’s
2. The med will immediately react with blood stream.
3. verify rate of admin w/med ref or pharm
4. Severe adverse rxn if delivered too quickly
5. The med cannot be stopped
6. The med cannot be reversed.
7. Avoid dose calc errors during prep
8. know the 8 rights of meds and double verify with another RN.
9. know desired action and SE of every med
10. If ANTIDOTE for med have available during administration.
11. when admin of potent med (but really all meds) assess vital signs before, during, and after infusion. - 7What are 3 IV administration advantages that will benefit the patient?1. Useful in emergencies-fast acting delivered fast.
2. Delivers constant therapeutic blood levels
3. Some oral meds are highly alkaline AND irritating to either muscle or SbQ (direct inj) So an IV can deliver med w/ less discomfort. - 8Which of the 3 IV method administrations is considered the safest and easiest?1. Large-Volume Infusions
mixing them in large volumes of fluids is the safest and easiest because the med is not in a concentrated form, the risk of SE, or worse a fatal rxn. is minimal when infused over the prescribed time frame. - 9Name a few medications that are commonly added into Large-Volume IV Infusions?1. Vitamins
2. Potassium Chloride - 10Name a few compatible large-volume IV fluids which medications are diluted in?1. Normal Saline
2. Lactated Ringer’s Solution - 11Large-Volume Infusion comes in what three volumes?1. 500 mL
2. 1000 mL
3. 3000 mL - 12One of the laws of 11 laws of IV administration is no. 4…So what can happen or what is the danger that occurs with continuous infusion at a RAPID rate?4. Severe adverse rxn if delivered too quickly
Answer: If the IV fluid is infused too rapidly, the patient is at risk for medication overdose and circulatory fluid overload. - 13What EBP current safety standard cited by the TJC in 2016 NO LONGER SUPPORTS what practice on a routine basis?1. Nurses mixing medications into IV fluids.
- 14Many patient safety risks came about due to what 3 types of nursing errors?1. Incorrect calculations
2. non aseptic preparations
3. Incorrect labeling when the RN needed to prepare meds in IV containers on patient care units. (when RN’s EOC on patient care units were interrupted) - 15What then is the current 10 best practices to be included in the use of IV medication administration?1. Use of IV medications that come in standardized concentrations AND dosages.
2. Standardized procedures for ordering, preparing, and administering IV medications.
2. Ready-to-administer doses when possible
3. Nurses only mix meds into IV fluids in emergency situations.
4. The nurse NEVER prepares high-alert medications (eg, Heparin, dopamine, dobutamine, nitroglycerin, potassium, antibiotics, or magnesium) on a patient care unit.
5. check w/pharmacist before mixing an IV med in a container.
6. If pharmacist says that you need to prepare the med, then ask another nurse to verify your med calc. and have her watch during the procedure to ensure you prepared safely.
7. Always ensure IV fluid and medication is compatible (a pedi fluid bag would not match an adult med infusion-get it).
8. always prepare your medication in a syringe using strict aseptic technique.
9. Clean the injection port of the IV bag with an alcohol swab.
10. remove the cap from the needle filled with medication you prepared and insert the needle through the IV port. - 16What then is the current additional best practices to be included in the use of IV medication administration after inserting the needle through the IV port?1. Push the plunger to instill medication into the IV fluid and mix the solution by turning the IV bag gently end-to-end.
2. Final step is to attach a medication lab with start time, date, initials following ISMP safe label guidelines.
3. ADMINSTER MEDICATION to the patient at the prescribed rate. - 17What are 2 huge current best practice tips that will definitely keep are patient alive and safe?1. DO NOT ADD MEDICATIONS TO IV BAGS THAT ARE ALREADY HANGING-this is because their is no way to tell the exact concentration of the medication.
2. Only ADD medications to BRAND NEW IV bags. - 18When administering medications in large IV fusions 3 golden rules of the RN?1. regulate the IV rate according to the health care provider’s order.
2. Monitor Patient’s closely for adverse reactions to the medication and fluid volume overload. rule no. 4-safety
3. Check the site frequently for infiltration and phlebitis. - 19Definition of an Intravenous Bolus/Push is?An IV bolus involves or is defined by the act of introducing a concentrated dose of a medication directly into systemic circulation (see skill 32-6 on pp. 675-679)
- 20What is the advantage of using an intravenous bolus?1. because a bolus only req. a small amount of fluid to deliver the medication, this becomes an advantage for the patient when the amount of fluid that the patient can take is restricted.
- 21What is the most dangerous method for administering IV medications? Why?1. An Intravenous Bolus, aka PUSH is the most dangerous of the 3 IV admin methods.
2. The reason it is the most dangerous is their is NO, none, zero time to correct errors.
3. In addition a bolus may cause direct irritation to the lining of blood vessels. - 22Before administering a bolus describe 2 red flags that would not allow us to proceed?1. confirm placement of the IV line
2. Never give a med Intravenously if the site itself appears, swollen or edematous, or if the IV fluid cannot flow at the proper rate. - 23depending on the composition of the medication accidental injection of medication in the the tissues around a vein can cause 3 critical problems?1. pain
2. Sloughing of the tissue
3. Abscesses - 24When you read about a medication that carry a risk of adverse effects if administered too quickly what is best practice?1. Dilute and administer PIGGYBACK or via and Infusion pump
- 25How do we determine the rate of administration of an Intravenous bolus medication? Give an example or reason for your selected answer1. By the amount of medication that can be given each minute.
Example: patient is to receive 4 mL of a medication over 2 minutes, give 2 mL of the Intravenous bolus medication every minute.
This is why we look up each medication to determine the recommended concentration and rate of administration. - 26what does the acronym (ISMP) stand for?1. The Institute for Safe Medication Practices
- 27The ISMP recommended avoiding using terms such as ____ in orders with drugs that require administration over 1 minute or longer?1. IV PUSH
2. IVP
3. BOLUS - 28The ISMP recommended using descriptive terms such as ____ ? Why?1. IV over 5 minutes
Why: consider the purpose for which an IV medication is prescribed and ANY potential adverse effects related to the rate or route of administration. - 29Another way of administering IV medications is through small amounts (50 to 100 mL) of compatible IV fluids. This is called ____?Volume-controlled Infusions
- 30A fluid that is within a secondary fluid container separate from the primary fluid bag. The container will then connect directly to the primary IV line or to separate tubing that inserts into the primary fluid bag is called _____?Volume-Controlled Infusions
(example see skill 32-7 on pp. 679-683) - 31Name 3 types of Volume-Controlled Infusion Containers?1. Volume-Control administration sets (e.g., Volutrol or Pediatrol).
2. Piggyback sets
3. Syringe Pumps - 32What are 3 advantages of using Volume-controlled infusions?1. It reduces risk of rapid-dose infusions by IV push. The medications are diluted and infused over a longer time interval (e.g., 30 to 60 minutes).
2. It allows for administration of medications (e.g. antibiotics) that are stable for a limited time in solution.
3. It allows for control of IV fluid intake - 33A _____ is a small (25 to 250 mL) IV bag or bottle connected to a short tubing line that connects to the upper Y- port of a primary infusion line or to an intermittent venous access?PIGGYBACK
(FIGURE 32-25 - 34The PIGGYBACK is a _____ or _____ system?1. microdrip
2. macro drip - 35Why is the set called a PIGGYBACK?the name PIGGYBACK is used because the small bag or bottle is higher than the primary infusion bag or bottle.
- 36In the PIGGYBACK set-up the main line _____ infuse when the PIGGYBACKED medication is infusing.DOES NOT
- 37PIGGYBACK FACT-The port of the primary set Intravenous line contains a MAGIC back-check valve that automatically will stop the flow of the primary set infusion once the PIGGYBACK infusion starts flowing.
Next- After the PIGGYBACK solution infuses AND the solution within the tubing falls below the level of the primary infusion drip chamber, the back check valve opens, and the primary set infusion again flows. - 38What is a Volume-Control Administration (e.g. Buretrol) sets?Well, these sets are small (150 mL) containers that attach just below the primary infusion bag or bottle. The set is attached and filled in a manner similar to that used with a regular IV infusion.
Note: follow the pkg. for directions on how to prime the sets. - 39What is battery operated and allows medications to be given in very small amounts of fluid (5 to 60 mL) within controlled infusion times using standard syringes?Syringe Pump
- 40A Saline Lock is a common term for ____ ?Intermittent Venous access
- 41A Intermittent Venous Access/Saline Lock is an _____?IV catheter capped off on the end with a small chamber covered by a rubber diaphragm or a specially designed cap. The special rubber-seal injection caps usually accept needle safety devices.
- 42What is the advantages to using an Intermittent Venous Access/Saline Lock catheter?1. Cost savings resulting from the omission of continuous IV therapy.
2. Effectiveness of nurse’s time enhanced by eliminating constant monitoring of flow rates.
3. Increased mobility, safety, and comfort for the patient. - 43before administering an Intravenous bolus or Piggyback medication into an Intermittent Venous Access/Saline Lock catheter you _____ ?1. check patency
2. check placement of the Intravenous site,
3. After you administer medication through Intermittent Venous Access/Saline Lock catheter site you must flush it to keep it patent.
4. Flush commonly is normal saline but some agencies will require the use of heparin. Refer to agency policy regarding care and maintenance of site. - 44How to Read the label on an Intravenous PIGGYBACK medication bag label: 1. John Jones 2. Room 2647 3. MR#123456 4. Hydrocortisone 5. (Solu-Cortef) 6. 100 mg 7. In D5W 8. IVPB 9. Total Volume 50 mL 10. IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 11. RPh Initials 12. Exp: 12/31/2020 13. Deaconess Hospital Pharmacy 14. Infuse medication over 20-30 minutes 15.1. Patient Name
2. Location
3. Second Identifier
(Date of birth, financial #, Encounter #, Medical Record #)
4. Generic name
5. BRAND name
6. Patient dose
7. Diluent
8. Route
9. Total Volume
10. Bar Code
11. Initials as needed
12. Expiration Date as needed in a MM/DD/YYYY format
13. Pharmacy information if required
14. Comments
15. Other information as required by state or federal law. - 45Administration of IV therapy in the home includes several medications, name 5?1. Antibiotics
2. Chemotherapy
3. Total Parenteral Nutrition
4. Analgesics
5. Blood Transfusions - 46Most patients typically receive their home IV therapy through a ____?long-term central venous catheter (CVC)
- 47Home health nurses are responsible for ____? When should you begin teaching the family about IV care mgmnt.?1. assess patient’s responses to the meds
2. monitor the CVC site
3. Teach Patient and their family caregivers how to admin infusions and maintain CVC
4. Carefully assess patients and their family ability to admin infusions
5. teach about S/S of infection or complications with equipment to include infusion pump.
Answer: Immediately at the home; your instruction will begin in the hospital often times before they go home.
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- Flashcards on Intravenous Administration, created by Wednesday Patches on 27/08/2018.
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- Wednesday Patches
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