2 IV Medication b

Question 1

CONCENTRATIONS

Answer 1

Some medications are provided as a “neat” solution (so it is given
without dilution)
 Others need to be diluted as they are either too potent or unstable in
plastic (therefore are provided in a glass ampoule and then added
later)

Question 2

Isotonic crystalloids have a tonicity equal

Answer 2

Isotonic crystalloids have a tonicity equal

Question 3

When a crystalloid contains fewer electrolytes than the plasma, it is
less concentrated and referred to as

Answer 3

hypotonic

Question 4

When a crystalloid contains more electrolytes than plasma, it is
referred to as

Answer 4

hypertonic.

Question 5

CONCENTRATION OF SOLUTIONS

Answer 5

mass of the solute divided by the volume of the solute

Question 6

RECONSTITUTING MEDICATION

DISPLACEMENT

Answer 6

Some IV medications are provided as powder in a glass
vial that needs to be made up to a form that can be
administered parentally.
 Depending on the volume of powder, there will be a
displacement value so adding water to a volume of
powder means you get more volume at the end.

Question 7

GENERAL RULES

Answer 7

If you are unfamiliar with any
aspect of the order, consult a drug
reference book.
 Focus on the task at hand.
 Never give a drug that someone
else has prepared.
 Avoid leaving a prepared drug
unattended.

Question 8

ADVERSE REACTIONS

Answer 8

Unwanted and/or unintended effects of the administration
of a drug.
Can occur immediately after the patient received the
medication, or be delayed for hours to days. Possible
signs and symptoms are skin rash, urticaria (itching),
nausea and vomiting

Question 9

ADVERSE REACTIONS can be

Answer 9

Iatrogenic

Drug sensitivity/allergy

Question 10

Iatrogenic

Answer 10

unintentional

Question 11

Drug sensitivity/allergy

Answer 11

occurs in an individual who has
been previously exposed to the drug and has developed
antibodies. Drug allergies can be manifested in a variety of
symptoms ranging from minor to serious.

Question 12

GUIDELINES FOR ADMINISTRATION

Answer 12

An IV line has been established patent.
 The patency of the line has been checked immediately prior to administration of
the drug.
 A clear prescription of the drug has been written and the medication chart
completed by the medical officer or a verbal order has been given by a medical
officer in the event of medical emergency.
 The general nature of the drug is known to the person administering it.
 Consent is given by the patient (if appropriate; not possible if emergency or
unconscious)
 The first dose of the drug has been administered by a medical officer or the
drug forms part of the list which permanent nursing staff may administer.
 Accreditation for dose administration is completed by the nursing staff member
giving it.
 The drug and its guidelines are included in the Gold Book / Drug Administration
Protocol.
 The dose and frequency is appropriate for the patient, as per guidelines.

Question 13

SAFETY CHECKS

Answer 13

Patient’s name & Medical Record Number – chart and patient’s name band
 No allergy
 Correct drug and expiry date
 Correct (appropriate) dose (strength) and route
 Correct time and frequency to be given
 Signature and date of order by Medical Officer
 Order written clearly and legibly
 Consent of patient
 Patent IV site
 Solution is compatible drug with whatever else is going through the site…..
 Checked with another person who is accredited to check IV medication
maybe CMO or another RN, NP etc.
 If a DD ( Schedule 4/8) administration MUST be witnessed by 2 people

Question 14

MORE CONSIDERATIONS OF SAFETY

Answer 14

Be diligent and follow all policies related to medication calculations,
preparation, and thorough assessment of patient status before and after an
injection. Medication errors are the most common preventable errors in health
care.
 Use a blunt filter needle or blunt needle when preparing injections. Never use a
needle when injecting IV medication. Always use a needleless system.
 After preparing the medication, always label the medication syringe with the
patient name, date, time, medication, and dose. Never leave the syringe
unattended.
 Administer the post medication saline flush at the SAME RATE as the IV
medication.
 Assess the patient’s symptoms and need for IV medication prior to
administration.
 Assess the patient’s understanding of the medication.
 Know the consequences of the medication

Question 15

POSSIBLE COMPLICATIONS OF IV’S

Answer 15

Allergic reactions – is it the first dose? Anaphylaxis
 Extravasation
Drug interactions because of incompatibilities
 Drug loss via absorption of IV containers and administration sets
 Errors in mixing techniques
 Speed shock
 Phlebitis

Question 16

DRUG INTERACTIONS

Answer 16

The combined effect of two (2)
or more drugs acting
simultaneously. Each drug may
have either a positive or
negative effect on the working
of the others

Question 17

types of drug intercations

Answer 17

antagonistic

synergistic

Question 18

antagonistic

Answer 18

lessens the

effectiveness of another drug

Question 19

synergistic

Answer 19

enhances the effectiveness of

another drug