Midterm #2 - IV Meds Flashcards
IV Methods
Intermittent Infusion
Continuous Drip Infusion (in the main primary IV bag)
IV Direct/ Push
IV Bolus
IV Compatibility
Ability of a medication to retain its properties when combined with a diluent (eg NS)
IV Med Incompatibility
Undesired reaction between two drugs or a drug and a solution
Stability
Ability of substances to remain unchanged in the presense of other substances
Continuous Infusion
Infusion of IV solution at a constant rate.
May be the primary infusion.
Intermittent Infusion
Administration of IV meds at a prescribed interval.
May be delivered by pump or by gravity.
Upon completion, IV tubing is disconnected from IV access and IV access is flushed.
Promotes independence.
Q4h, q6h, q12h…
Primary Infusion
Main IV solution set up for the delivery of intravenous fluid or for maintaining vascular access during intermittent infusions
Secondary Infusion (Piggyback)
IV solution or med attached to the main set that is initiated concurrently or intermittently with the primary infusion.
Most common method to admin IV meds
Bolus
Concentrated med/solution given over a short period of time
May be given vi an infusion set or IV direct.
IV meds given too quickly cause negative outcomes (speed shock, death)
IV Direct
Administration of a med via syringe over a specific period of time (greater than 1 minute)
Into the lowest med port or directly into the cap of a IV catheter extension set.
IV Push
Rapid admin of a bolus of med via syringe
Based on the need for a rapid response to a med (eg. CPR)
KVO
Maintenance of a vascular access device “to keep the vein open”.
Continuous infusions for KVO MUST contain a specific rate of infusion ordered by the physician
TKVO - 10- 25 mL/h
Advantages of IV med admin?
Quick therapy effect of med
When med too irritating to be admin by another route
Control of how much to administer - stop or hold
Unconscious Patient med admin
Disadvantages of IV med admin?
Rapid severe reaction to med Fluid overload IV site complications: phlebitis, extravasation, infiltration Allergic reaction - anaphylaxis Speed shock
Anaphylaxis Early S+S
Uneasiness Anxiety Impending doom Erythema Urticaria Pruritis Angioedema Feeling of warmth Resp: lump in throat, hoarseness, coughing, sneezing, dyspnea, stridor
> > > Epinephrine IM route
Anaphylaxis Late S+S
Unable to breathe d/t airway obstruction Laryngeal edema and bronchospasm Hypotension Fluid shift Tachycardia or bradycardia Ischemia d/t vascular dilation Cardiac arrest Coma N+V Cramping Diarrhea
Anaphylaxis Prevention
Allergy screening prior to med admin Remove antigen - STOP infusion Stay with Pt Call for help - Call a code Apply O2 Vitals, SpO2, assess ABC KVO/ Start IV Emotional support Be aware of anaphylaxis kit, crash cart location
IV monograph
Provides drug information to nursing, medical and pharmacy staff. Dose rate charts and route information Contraindications Cautions Reconstitution instructions Compatibility Adverse effects Therapeutic drug monitoring
Advantages of Intermittent Infusions
- Prevent harm to the Pt - med is given slowly
- Multiple admin of meds through a single line
- It provides high serum blood levels for only a short period of time
- Reduce the risk of rapid infusion - less potential for adverse reactions
Compatibility of solutions and meds
Check compatibility before admin
If an incompatibility exists between solutions/meds there must be flushing between doses to prevent mixing OR they have to be run separately (separate lumens)
If insuff info - solutions/meds are considered incompatible
IV Bolus
Amount of concentrated dose of medication directly into the vein of an existing IV access
Via the lowest injection port of an existing IV infusion or an intermittent needless connector over a specific period of time at a safe rate.
Process: Pre-flush (if applicable) Med admin (as per monograph) Post-flush (at the same rate of the med administered) Monitor Pt and assess site
Bolus Advantages
More rapid effect
Can give multiple medications within shorter time frame
Minimize the potential for fluid overload for pts at risk
Fast onset for both desired and undesired effects
Bolus disadvantages
Greater potential for:
- IV site complications (check for patency and flush between multiple meds)
- Adverse reactions (be aware of SE prior to admin)
- Speed shock
- Venous irritation
Sandwich Flushing Technique
If the IV med is incompatible with the primary solution or med in the solution–
Stop infusion - primary line
Kink/occlude line above lowest port
Flush before and after.
If compatible - no need to “sandwich”
