Lab 2 - IV Medication Administration

Reconstitution of meds - scope of practice

direct supervision

peripheral IV fluids - scope of practice

indirect supervision

central line care - scope of practice

direct supervision

When do you replace IV lines?

every 24 hours

Can we complete direct IV administration?

No - this is not yet in our scope of practice

What is another term for IV intermittent infusion?

IV piggyback

Advantages of IV Med Administration

- direct access to circulatory system

- a route for administration of fluids and drugs to pts who cannot tolerate oral meds

- a method of rapid drug action

- more comfortable than SC/IM

Disadvantages of IV Med Administration

- possible drug interactions

- "speed shock" - administration of a drug too quickly

- fluid overload

- risk of infection

Hematoma & Ecchymosis

bruise, blood clot under the skin

S&S: redness, bruising, swelling and discomfort, resistance during catheter flushing

Phlebitis

vein inflammation

S&S: swelling, warmth, redness, tenderness, palpable cord, streak formation

Infiltration & Extravasation

IV fluid escapes from the vein into the surrounding tissue. Extravasation is when the IV fluid is a vesicant medication that can cause damage to the tissues when it leaves the vein.

S&S: swelling, discomfort, burning, tightness, cool skin, blanching, decreased flow rate

What are potential systemic complications?

speed shock

bloodstream infection

fluid overload

venous air embolism

What is the 10% rule of mixing medications into minibags?

If the volume of the medication is less than 10% of the volume of the minibag, you can add it.

If the volume of the medication is greater than 10% of the volume of the minibag, you must first remove liquid from the minibag

When would IV fluids be indicated?

severe dehydration

electrolyte imbalance

NPO for surgery

medications that can only be given parenterally

administration of TPN or blood products

Isotonic

osmolality is similar to plasma so it expands ECF but does not change the size of RBCs

Hypotonic

used to replace fluid in cells because the fluid contains fewer solutes than plasma and will move into the cells

Hypertonic

contain more solutes than plasma and draw water from the cells into the ECF

How often should a saline-lock be flushed?

before medication administration, after medication administration, before starting a new IV line, and every shift

How much fluid is used to saline-lock an IV?

minimum of 3 mL

What does red writing on a minibag indicate?

that it has potassium