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NURS 3530 - Nursing Skills 3 > Lab 2: Med Prep and Admin > Flashcards

Lab 2: Med Prep and Admin Flashcards

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1
Q

what 3 methods are used to administer meds IV

A
  1. as mixtures within large volume of IV fluids
  2. by injection of a bolus (small vol) of medication thru an existing IV infusion line or intermitent venouc access (heparin or saline lock)
  3. volume-controlled infusion
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2
Q

what is a piggyback infusion

A
  • infusion of a solution containing the med, and a small vol of IV fluid thru an existing IV line
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3
Q

when administering potent meds, what should you assess and when

A
  • vitals before, during, and after
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4
Q

what are advantages of administering meds via IV (3)

A
  • used in emergencies when a fast-acting med must be given quickly
  • preferred when constant therapeutic lvls need to be established
  • meds that are highly alkaline and irrtate the muscle & subcut tissue cause less discomfort if given IV
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5
Q

of the 3 methods of giving meds IV, what is the safest and easiest

A
  • mixing meds in large volumes of fluid
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6
Q

what are large-volume infusions of meds diluted in

A
  • large volumes (500-1000 mL) of compatible fluids

ex. NS, LR

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7
Q

what is a benefit to large-volume infusions of meds (2)

A
  • pharmacist often adds the meds to the primary container of IV solution to ensure asepsis & reduce possibility of med erros
  • not concentrated = risk of s/e or fatal rxns is minimal if given over prescribed time
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8
Q

what are 2 examples of meds often given via large-volume infusions

A
  • vitamins

- potassium chloride

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9
Q

what are risks associated w large-volume infusions

A
  • circulatory fluid overload (esp. if given too rapidly)
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10
Q

what is an IV bolus or “push”

A
  • involves the introduction of a concentrated dose of a med directly into the pts systemic circulation
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11
Q

what is an advantages of giving a med IV bolus

A
  • requires only small amt of fluid to give the med = useful if on restricted fluids
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12
Q

what are risks associated w IV bolus (3)

A
  • most dangerous method
  • have no time to correct the error
  • may irritate the lining of the blood vessels
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13
Q

what should you do before administering meds via IV bolus

A
  • confirm the placement of the IV line by obtaining a blood return from the IV catheter or needle
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14
Q

what does the inability to obtain blood before doing IV bolus mean

A
  • suggests the needle or catheter is either in the pts tissues or resting against the vein wall
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15
Q

never give a med intravenously if… (2)

A
  • the insertion site appears puffy or edematous

- if the IV fluid cannot flow at the proper rate

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16
Q

accidental injection of a med into the tissues around a vein can cause (3)

A
  • pain
  • sloughing of tissues
  • abscesses
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17
Q

how do you determine the rate of admin of an IV bolus med

A
  • by the amt of med that can given per min

ex. if pt is to receive 4mL over 2 min, rate = 2mL/min

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18
Q

what are volume-controlled infusions of meds

A
  • IV medications administered thru small amounts (50-100mL) of compatible IV fluids
  • where the fluid is within a secondary fluid container, separate from the primary fluid bag & the container connects directly to the primary IV line or to separate tubing that inserts into the primary line
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19
Q

what are 3 types of containers that are volume-controlled admin sets

A
  1. piggyback sets
  2. tandem sets
  3. mini-infusors
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20
Q

what are the advantages of volume-controlled med infusions (4)

A
  • risk of rapid-dose infusion by IV push is reduced
  • meds are diluted and infused over longer time intervals (30-60 min)
  • meds that are only stable for a limited amt of time in solution (ex. antibiotics) can be administered
  • IV fluid intake can be controlled
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21
Q

what is a piggyback

A
  • a small (25-250 mL) IV bag or bottle that connects to short tubing lines that, in turn, connect to the upper Y-port of the primary infusion line or an intermittent venous access
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22
Q

how is the piggyback set up in relation to the primary infusion bag

A
  • set higher
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23
Q

does the primary line infuse while the piggyback med is?

A
  • no

- the port of the primary line contains a back-check valve that automatically stops flow of the primary infusion

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24
Q

when does the primary line begin to infuse w a piggyback setup

A
  • after the piggyback solution infuses and the solution within the tubing falls below the lvl of the primary infusion drip chamber , the back check valve opens and the primary infusion flows again
25
Q

what is a tandem setup

A
  • small (25-100mL) IV bag or bottle connected to a short tubing line that connects to the lower Y-port of a primary line or to intermittent venous access
26
Q

what height is the tandem set to in relation to the primary line

A
  • same height
27
Q

does the primary line infuse while the tandem is?

A
  • yes
28
Q

what is important to monitor w a tandem setup

A
  • monitor closely –> if it is not immediately clamped when the med is infused, the IV solution from the primary line will back up into the tandem line
29
Q

what is a mini-infusion pump

A
  • battery operated pump

- allows meds to be given in v small amts (5-60mL) within controlled infusion times using standard syringes

30
Q

read skill 33-6 (5th edition) on adding meds to IV fluid containers

A

…

31
Q

after adding a med to a new IV fluid container, what should you include on the label (3)

A
  • name & dose of med
  • date & time of admin
  • initials
32
Q

read skill 33-8 on adminstering IV meds by piggyback, intermittent IV infusion sets, and mini-infusion pumps

A

…

33
Q

how many times should you compare the label of the med w the MAR while preparing the med

A

-2 times

34
Q

before flushing a line or adding a med to an IV fluid with a syringe, what should you do?

A
  • remove any bubbles
35
Q

why cant’ you leave a line connected with nothign infusing

A
  • will clot off
36
Q

what are parental medications

A
  • medicine taken into the body or administered in a manner other than thru the digestive tract
  • IV, subcut, IM injection
37
Q

what are the 2 parts to giving IV meds

A
  1. prepartion

2. admin

38
Q

what is included in preparation of an IV med (2)

A
  • reconstitution (not always required)

- dilution

39
Q

what are prefilled syringes designed for? what should they not be used for?

A
  • designed for flushing vascular access devices & saline locks
  • should not be used for reconstituion or dilution of medications
40
Q

how often should needleless connectors be changed

A
  • every 7 days
  • if contaminated
  • residual blood remains in the device after it is flushed
41
Q

what is the purpose of the blue end syringe tip caps

A
  • required to unsure sterility of the end of ur med syringe or IV tubing
42
Q

when should blue end syringe tip caps be replaced

A
  • if the end of ur syringe or IV tubing becomes contaminated
43
Q

what are the 5 steps for preparing IV meds

A
  1. dosage & check rights
  2. reconsitution (powder to liquid)
  3. final conc. (mg/mL)
  4. obtain ordered dose (how many mL do i need from the vial for the dose)
  5. dilute
44
Q

what should you do/check prior to admin (4)

A
  • do i have a conc lower than the max conc allowed
  • what rate
  • is the med compatible w the current infusing solution
  • what rxn might the pt have to this med
45
Q

what is important to remember regarding total volume when reconstituting IV meds

A
  • if you are adding a large amt of med (ex. 10 cc) to a mini bag, this will alter your rate since you will now have the vol of the minibag + the vol of med
    = most accurate to calculate the exact pump rate with the exact volume in your mini bag
  • if vol is less than 5, no need to recalculate
46
Q

what is back priming

A
  • method to clear the air out of a secondary set
47
Q

what is the benefit of back priming

A
  • allows for incompatible secondary meds to be given w the same secondary set bc it will cleared of any prior med
  • easy & safe
  • maintains a closed system (does not require disconnecting)
  • no wasting of meds
48
Q

how often do IV bags need to be changed

A
  • q24 hr
49
Q

how often do primary and secondary tubing need to be changed

A
  • q96 hr

- if suspected contamination or the integrity of the system has been compromised

50
Q

how often does tubing that is disconnected from the pt need to be changed

A
  • q 24 hr
51
Q

what does the 96 hr tubing not apply to (4)

A
  • admin of lipids, TNA, propofol, blood
52
Q

what is important to note regarding multiple secondary sets?

A
  • they are not best practice d/t multiple access to the system = increased chance of infection
  • back prime the tubing in between admin of secondary meds
53
Q

if sets have different expiry dates, what should you do

A
  • discard together when the first expires
54
Q

when should secondary sets or CIVA tubing be disconnected from the primary sets

A
  • not until therapy is completely d/c
55
Q

if a pt has a newly inserted central line, what is imp to not do

A
  • do not use tubing that was infusing into a peripheral catheter
56
Q

after each piggy-back med, what is required

A
  • a flush to clear the line of med
57
Q

why must you flush after each piggy-back med

A
  • gives entire dose to pt

- prevents contact of incompatible meds

58
Q

what is important to program when setting up a piggy back med

A
  • “call back” alerts –> notifies you when ur volume in the mini bag is complete
59
Q

what should you do when ur pump “calls you back” after a piggy back med

A
  • make sure secondary bag is empty
  • program in a 15 mL flush at the same rate

this will draw fluid from ur primary bag to flush the line while keeping it a closed system

NURS 3530 - Nursing Skills 3 (4 decks)

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