Methods Flashcards
If a medication is ordered to be given Intravenously typically what procedures/routines apply?
- IV Abx/medications (in a vial) are added to a mini bag consisting of either Normal Saline or 5% Dextrose.
- IV narcotic/anti-nausea medications are also added to a mini bag consisting of NS and 5% Dextrose and typically infuse within 10 – 15 minutes.
- If the patient requires a medication/narcotic to be infused quickly via IV due to pain issues/nausea, etc. the RN may administer as an IV Push.
What is the medication profile?
A profile of all medications taken by the patient (current or discontinued) in the previous 2 weeks.
This is sent daily by the Pharmacy to the Nursing Unit.
What happens to the patient profile in the patient’s chart when the Pharmacy sends a new one?
Discard the old profile
Where is the Medication Profile filed?
In front of the current Physician’s Order or in the Medication Section
intravenous therapy or IV therapy
The administration of fluids, medications, and blood or blood components directly into a vein.
What is an intravenous drip?
Continuous administration of fluids during IV therapy
What is the fastest way to deliver fluids and medications throughout the body?
intravenous route
What are 5 uses of intravenous therapy?
- Maintenance therapy – provides the necessary nutrients to meet the daily needs for water, electrolytes, and nutritional replacement.
- Replacement therapy – when a patient has had a deficit of fluids and electrolytes over time due to situations such as vomiting, diarrhea, and starvation.
- When a patient requires a rapid or continuous infusion of medications.
- When a patient is unable to take medications by mouth due to vomiting, unconsciousness, or unwillingness to take medications orally.
- When a patient requires transfusion of whole blood or blood components.
What are the most commonly used intravenous solutions?
Specific combinations of water, sugar (in the form of dextrose), sodium chloride, and other electrolytes
Who administers the IV therapy?
RN
IV fluids come in what size bags?
50 ml to 1000 ml
IV Bolus / IV Push
A patient needs a large volume of fluids immediately
RN needs to be notified immediately
What can be infused into intravenous therapy?
- fluids
- electrolytes
- medications
- nutrients
How is the flow rate regulated?
Roller clamp or IV pump
How often is an IV bag changed?
Every 24 hours
How often is the IV tubing changed?
Every 72 hours
How often is the IV changed?
Every 7 days
How often is the IV dressing changed?
Every 2-3 days
Intravenous therapy can be used _____
TKVO
Why is intravenous therapy referred to as a drip?
Many systems of administration employ a “drip chamber”
What is an intermittent infusion?
Intravenous therapy that uses the same techniques as an intravenous drip, but after the complete dose of medication has been given, the tubing is disconnected from the IV access device.
Is an intermittent infusion continuous?
No, but is used when patient requires medications/antibiotics at certain times
What is a saline (heparin) lock?
A venous access device placed on a peripheral intravenous catheter. It establishes an intermittent line when IV fluids are no longer needed but IV entry is still required.
When is a saline (heparin) lock used?
Commonly used for the administration of medication and consists of a plastic needle with an attached injection cap.
What is a saline flush?
When a saline lock is ordered by the Physician the RN will automatically flush the device with a saline solution prn. The saline lock is kept patent by saline flushes.
What is an infusion pump?
An electrical device used in the administration of IV fluid and it measures a precise amount of fluid (regulates drips per hour) to be infused for a stated amount of time.
Where do you order the infusion pump from?
Sterile Supply Dept.
What are the 3 components of an IV order?
- IV
- Solution
- Flowrate
5% DW (D5W)
5% dextrose in water
5% D/S
5% dextrose in saline
2/3 1/2 (Code 8)
2/3 dextrose and 1/3 saline
NS (Normal Saline)
Saline solution
D5 1/2 NS
5% dextrose in 1/2 strength NS
D5 1/4 NS
5% dextrose in 1/4 strength NS
D5LR
5% dextrose in Lactated Ringer’s
5% DW c̅ 20 mEq KCl/L
5% dextrose in water with 20 milliequivalents of potassium chloride per liter
What are 2 IV fluid additives?
- electrolytes
- KCl
If there is a change in the solution or flowrate of an IV, what needs to happen?
Physician must write a new order
What happens to existing orders when a new order is given?
New orders cancel existing orders
Order: June 2
IV D5NS @ 125 ml/hr
New order: June 9
∆ IV to 80 cc/hr
a) What happens to the original IV order on the Kardex?
b) How should the new order appear on the Kardex?
c) Do you need to do anything with the MAR?
a) Previous order is erased, new date is noted and changes made.
b) Should read:
June 9 IV D5NS @ 80cc/hr
c) No
Order: Sept 4
IV D5W c̅ 20 mEq KCL/L @ 125 ml/hr
New order: Sept 6
∆ IV to IV D5NS c̅ 20 mEq KCl/L
a) What happens to the original IV order on the Kardex?
b) How should the new order appear on the Kardex?
c) Do you need to do anything with the MAR?
a) Previous order is erased, new date is noted and changes made.
b) Should read:
Sept 6 IV D5NS c̅ 20 mEq KCl @ 125ml/hr
c) D/C first order which will be on the current MAR and write the new order in the next available line on the MAR
Should read:
IV D5NS c̅ 20 mEq KCl/L @ 125 ml/hr
