Nursing Skills and Procedures for Nursing Care Three

Purpose of Training: The video focuses on essential nursing skills, particularly skill competencies in the nursing care three class.
Key Skills Covered:
- IV push medication
- Hanging primary tubing for continuous infusion
- Hanging a secondary infusion (intermittent or IV piggyback)

Initial Steps:
- Knock on the patient room door (e.g., "Hello, Mr. Jacobson. My name is Ashley. I'm going to be your nurse today.")
- Perform hand hygiene before proceeding with care.
- Close the door and pull the curtain for patient privacy.
Logging In:
- Use a computer to check the patient's information.
- Scan patient’s armband to retrieve their name, date of birth, and allergies.
- Access the MAR (Medication Administration Record) once logged in.

Medication Identification:
- Check MAR for medications ordered (e.g., Ondansetron for nausea).
Gather Supplies:
- Obtain Ondansetron vial from the Pyxis Room or skills lab.
- Prepare supplies: flushes, 3 mL syringe with a safety needle, green sterile caps.
Initial Checks:
- Confirm patient hasn’t received Ondansetron in the last 6 hours.
- Verify IV status (check for signs of infiltration: redness, swelling, pain).
Performing the IV Push:
1. Maintain aseptic technique:
- Wear gloves when necessary.
- Clean the area with alcohol swab for 30 seconds if needed.
1. Connect the normal saline syringe to IV and flush to check for patency:
- A positive blood return indicates a patent IV.
- If there's no return, monitor for infiltration signs.
1. Prepare the medication:
- Clean the top of the Ondansetron vial with an alcohol swab.
- Draw up 2 mL for a 4 mg dose (removing air bubbles).
1. Administer medication over 2-5 minutes:
- Observe patient for any adverse reactions.
- Use the push-pause method for administering the IV.
1. After administration:
- Flush the IV again to maintain patency, documenting any observations during the process.

Setup:
- Verify patient identity and medication (0.9% sodium chloride).
- Gather necessary supplies such as a primary infusion set.
Hanging Procedure:
1. Open sodium chloride bag and remove tags from tubing.
2. Clamp the tube to avoid air bubbles in the line.
3. Spike the IV bag carefully, ensuring not to touch the spike to any surfaces.
4. Prime the tubing:
- Allow some fluid to enter the chamber and unclamp it to let it run through to remove air.
1. Insert IV tubing into the Alaris pump module:
- Load it correctly into the machine.
1. Set infusion parameters:
- Confirm with MAR (e.g., rate of 125 mL/hour). Press start to begin infusion.

Overview: Typically used for administering antibiotics alongside a primary fluid.
Prepare Supplies:
- Cefazolin antibiotic with corresponding secondary infusion set (short set).
Administration Process:
1. Ensure the patient is not allergic to Cefazolin by checking the MAR.
2. Follow aseptic technique to prepare the secondary tubing:
- Spike the IV bag with the antibiotic and prime the tubing.
1. Hook the secondary tubing to the primary line:
- Ensure that the clamp of the primary line remains open for the primary fluid to continue while administering the secondary infusion.
1. Program the pump correctly for the Cefazolin:
- Select medication on the infusion module, input dosages and run rate (e.g., 200 mL over 30 minutes).
- Monitor patient during infusion, looking out for signs of adverse reactions.

Monitoring & Documentation: Throughout the infusion process, continually educate the patient about signs of infiltration, ensuring they know when to alert a nurse. Remind patients that IV tubing should be changed according to facility policy (e.g., every four days for continuous infusions or daily for intermittent infusions).
Final Steps: Clean up the workstation, dispose of absorbent materials appropriately, and document the care session accordingly.