PREPARATION & ADMINSTRATION OF CONTRAST MEDIA & IV SOLUTIONS Flashcards
- administration of an undiluted drug directly into the systemic circulation
• Used when a an emergency medication cannot be diluted or in
• Introduced directly into a vein by venipuncture or into an existing IV line
DIRECT IV PUSH
TWO (2) MAJOR DISADVANTAGES TO THIS METHOD OF DRUG ADMINISTRATION:
Any error in administration cannot be corrected after the drug has entered the patient
• Before administering a balus, you should look up the maximum Concentration recommended for particular drug and the rate of administration.
• Allow medications to be administered intravenously without requiring repeated needle sticks Continuous IV. infusion
• Needleless are preferred as they reduce the risk of needle stick injuries among health care workers
With the needleless system, the injectionadapter may be affixed at the time of I.V.catheter placement, allowing a close system to be maintained.
INTERMITTENT INFUSION DEVICES
THREE (3) COMPLICATIONS THAT ARE KNOWN TO BE A RISK WITH VENIPUNCTURE IF THE HEALTHCARE PROVIDER DOES NOT USE PROPER SKILL
Hematoma
Infiltration
Nerve damage
• If the angle of insertion is too high when the device is introduced into the tissue and veins
The needle will pass completely through the vein lumen and puncture the underside of the vein
HEMATOMA
If an I.V. fluid is hanging for infusion into the patient and the access is dislodged or the insertion points enlarges causing fluid backflow, this will cause an
infiltration.
The best way to avoid an infiltration is frequent site assessment for any discomfort or swelling no matter how
small.
INFILTRATION
May occur when excess manipulation of the device is done during access attempts
Proper angle of insertion and minimal
manipulation of an I.V. device will help to avoid coming in contact with a nerve
NERVE DAMAGE
May consist of infusions of crystalloids,
colloids, and blood products or a
combination of both crystalloids and
colloids.
INTRAVENOUS FLUIDS FOR IV ACCESS
& MAINTENANCE IV FLUID THERAPY
INDICATIONS
- Volume resuscitation
- Maintenance fluid
- Vehicle for IV drugs
- KVO (keep vein open)
Dextrose is a form of glucose (sugar)
Injected into a vein through an IV to replace lost fluids and provide carbohydrates to the body
Treat low blood sugar, insulin shock, or dehydration
Serves as a diluent (liquid) for preparing injectable medication in an IV bag.
DEXTROSE IN WATER SOLUTIONS
Dextrose 5 in .9 Sodium Chloride is a
prescription medicine used to treat the symptoms of hypoglycemia.
This may be used alone or with other
medications.
DEXTROSE IN SALINE SOLUTIONS
Normal saline is the chemical name for salt (generic name: sodium chloride).
It is a sterile, nonpyrogenic crystalloid fluid administered via an intravenous solution.
SALINE SOLUTIONS
You must demonstrate concern for the patient’s comfort as well as confidence in your ability to perform the procedure.
Provide patients with a brief explanation of the procedure, including any non routine techniques to be
used, such as additional site preparation for collection of blood cultures.
PREPARE THE PATIENT
Patients should not be told that the procedure will be painless.
Verify that he or she has completed any pretest preparation, such as fasting (nothing to eat or drink except water for 8 to 12 hours before the procedure)
or abstaining from medications that can interfere with laboratory testing.
PREPARE THE PATIENT
When you have located an appropriate vein, release the tourniquet, and cleanse the site using a 70 percent isopropyl alcohol prep pad to
prevent microbial contamination of either the patient or the specimen.
CLEANSE THE SITE
Use a back-and-forth motion, creating friction to clean an area 2 to 3 inches in diameter.
For particularly dirty skin, repeat this procedure using a new alcohol pad.
CLEANSE THE SITE
While the alcohol is drying, make a final survey of the supplies at hand to be sure everything required for the procedure is present, and then assemble the equipment.
Screw the stopper- puncturing the end of the double-ended evacuated tube needle into the ETS holder.
The needle and holder may come preassembled by the manufacturer.
Do not remove the sterile colored cap from the other end of the needle.
insert the first tube to be collected into the tube holder up to the designated mark.
After the tube is pushed up to the
mark, it may retract slightly when pressure is released.
ASSEMBLE THE PUNCTURE EQUIPMENT
Reapply the tourniquet and ask the patient to make a fist again.
Be careful not to touch the cleaned puncture site.
PERFOM THE VENIPUNCTURE
Hold the ETS holder or syringe securely in your dominant hand with your thumb on top and the other fingers
below.
Immediately before entering the vein, remove the needle plastic cap and visually examine the point of the needle for any defects, such as a bent or rough
(barbed)
Examine the needle
Use the thumb of your non-dominant hand to anchor the selected vein while you insert the needle
Place your four fingers on the back of the patient’s arm, and pull the skin taut, which will keep the skin tight and help prevent the vein from slipping to the side when the needle enters.
The median cubital vein is the easiest to anchor and the basilic vein is the most difficult
Anchor the vein
Place the ETS holder or the syringe in your dominant hand with your thumb on top, close to the needle hub, and your remaining fingers below the holder.
Align the needle with the vein and insert it, bevel up, at an angle of 15 to 30 degrees depending on the depth of the
vein.
insert the needle
If the tourniquet is still on the patient’ arm, remove the tourniquet before removing the needle.
Failure to remove the tourniquet before removing the needle may produce a bruise or hematoma.
Activate the needle safety device if it is designed to function while the needle is in the vein.
Place the folded gauze over the venipuncture site, withdraw the needle in a smooth swift motion, and
immediately activate the safety device.
Apply pressure to the site as soon as you have withdrawn the needle.
REMOVE THE NEEDLE
Immediately dispose of the contaminated needle, with the safety device activated, and the ETS holder as a single unit in an acceptable sharps container.
Under no circumstance should the needle be bent, cut, placed on a counter or bed, manually recapped, or
removed from the tube holder after use.
DISPOSAL OF THE CONTAMINATED NEEDLE
Bleeding at the venipuncture site should stop within 5 minutes.
Use paper tape for patients who are allergic to adhesive bandages.
Instruct the patient to remove the bandage after a minimum of 15 minutes to avoid irritation and to avoid
using the arm to carry heavy objects for a minimum of 1 hour.
BANDAGE THE PATIENT’S ARM
Before leaving the patient’s room, dispose of all contaminated supplies, such as alcohol pads, gloves,
and gauze, in a biohazard container.
Place needle caps and paper in the regular waste container.
Sanitize your hands before leaving the area.
DISPOSE USED SUPPLIES
