Module 12 - Intravenous Medications 3

Potassium

A key factor in the cardiac action potential.

↑ Hyperkalemia: heart palpitations, muscle spasms.

• Interventions: Some drugs will shift it back into intracellular spaces.

↓ Hypokalemia: weak, thready pulse, muscle weakness and nausea.

• Interventions: Supplement with medications to increase levels.

Phosphate

Plays a key role in our energy; commonly related to malnourished states.

↑ Hyperphosphatemia: muscle cramping, weakness, tachycardia, diarrhea, nausea, abdominal cramping.

• Interventions: Diuretics, oral antacids

↓ Hypophosphatemia: weakness, fatigue, disorientation, irritability, seizure, coma.

• Interventions: IV sodium phosphate or potassium phosphate.

Magnesium

Plays a key role in cardiac action potential, nerve cell conduction, transmitting CNS messages, and maintaining neuromuscular activity.

↑ Hypermagnesemia: change in LOC, respiratory depression, muscle weakness.

↓ Hypomagnesemia: hypotension, GI discomfort, cardiac arrhythmias, muscular irritability, Chvostek’s and Trousseau’s sign.

• Interventions: supplement with medications.

Calcium

Most located in bone and teeth; blood coagulation, neuromuscular contraction, needs vitamin D to absorb in GI.

↑ Hypercalcemia: severe thirst and polyuria, drowsiness, confusion, dry mouth, nausea and vomiting, lack of appetite, fatigue, restlessness, abdominal and back pain.

• Interventions: fluids, bisphosphonates.

↓ Hypocalcemia: muscle cramps, tingling, numbness, irritability, reduced cognitive ability, seizures, ECG changes, decreased BP, bone fractures, abnormal clotting.

• Interventions: IV calcium chloride.

Central Line Medication Administration

Strict Sterile Asepsis: Infection prevention

• A minimum 15-second vigorous scrub-the-hub is required.

PICC - if locked, access with a 10mL syringe using the start-stop method before and after administration of medication.

Central Venous Catheter: if locked, access with a 10mL syringe using the start-stop method before and after administration of medication.

Claves must be used on the ends.

Pediatrics

Weight-based - priority is to ensure that each medication is safe for that specific child’s weight.

Safe doses range from min to max for a 24-hour period.

Small miscalculations can lead to errors - do not round.

Use a smaller syringe (often a tuberculin syringe)

IM doses < 1mL (size dependent)

SubQ < 0.5mL

IM < 0.5mL