UNIT 3 IVP and IVPB – Flashcards

- Used for patients requiring intermittent IV medications - Single dose injection of concentrated soln directly into IV line - Consist of: catheter with tubing capped w/injection port - Drug administered Slow IV Push (SIVP) over at least 1 minute - Allows freedom! - Be sure to dress, anchor and flush! IAW hosp policy

- aspirate - flush - push med - flush - lock

1. What is the ordered dose in mL? 2. How fast do I want to "push" it (administer over how many minutes)? Check your drug book! 3. How many mL would you draw up to administer (push) the ordered dose? 4. How many mL will you give per minute? 5. How many total minutes will you administer this medication over?

How many mL/hr do I want to infuse the medication?

Administer at rate of 20mg/min

- Antimicrobial swab - Watch w/second hand or IV pump - Clean gloves - Prescribed medication - Syringe w/needle (23-25 ga) or - Needleless injectors - MAR, BMV, WOW, COW, etc

1. Release folded tubing after each increment of drug has been administered at prescribed rate 2. 1 mL of NS (at same rate of med admin) to flush tubing after bolus to ensure residual med in tubing not delivered too rapidly 3. IV warm compress 6. Incompatible meds - flush with NaCl before & after medication.

- it ensures injection of medication into the bloodstream (unless small needle/catheter). - If the IV is a small gauge (22-25) placed in a small vein, a blood return may not occur, even if IV is intact. --> watch for infiltration while administering

- DEXTROSE!

- it may take as long as 30 minutes to reach the patient. Consider how fast IVF is flowing to determine whether a flush of NaCl is in order after administering the medication.

- irritation of the vein --> This DOES NOT mean the IV is "bad." - Placing a warm pack over the vein or slowing the rate may relieve discomfort.

- the bolus may be given by flushing the tubing with NaCl before and after the medication bolus. (Consult policy)

- to evaluate the patient 's response to administered medication.

I. Assess IV site for inflammation or infiltration II. If using pump - pause it --> put on clean gloves III. Select injection port closest to venipuncture --> clean with wipe IV. Steady port with nondominant while inserting syringe (needleless) into center of cleaned port. V. Move nondominant hand to just above port and fold tubing between fingers VI. Pull back slightly on plunger just until blood appears in tubing. (check for blood return) ** small gauge is exception! VII. Inject medication at recommended rate. VIII.Release the tubing. Remove the syringe. Do not recap the used needle. Engage the safety shield. Release the tubing and allow the IV fluid to flow IX. Check IVF rate - restart pump.

- IF the line is patent, w/o s/s infiltration and IVF infuse without difficulty, proceed with administration. - Observe closely.

- Stop IVF & remove catheter. - Restart in different location. - Continue procedure

- the med and IVF are incompatible! - stop pushing the med - clamp the extension used for pushing - remove the extension and replace it - administer the medication

1. Pause pump 2. Glove 3. Port closest to venipuncture site 4. Fold tubing 5. Pull back plunger for blood 6. Inject medication 7. Release tubing...remove syringe 8. Restart pump

1. Back to basics 2. Release clamp 3. Aspirate for blood return 4. Gentle flush & "watch site" 5. Administer medication / timed

- at least q 8 hours or per hospital policy

1. Close the clamp on the short secondary infusion tubing. Using aseptic technique, remove the cap on the tubing spike and the cap on the port of the medication container, taking care to not contaminate either end. 2. Attach infusion tubing to the medication container by inserting the tubing spike into the port with a firm push and twisting motion, taking care to not contaminate either end. 3. Hang piggyback container on IV pole, positioning it higher than primary IV according to manufacturer's recommendations. Use metal or plastic hook to lower primary intravenous fluid container. 4. Place label on tubing with appropriate date. 5. Squeeze drip chamber and release. Fill to the line or about half full. Open clamp and prime tubing. Close clamp. Place needleless connector or needle on the end of the tubing, using sterile technique, if required. 6. Use an antimicrobial swab to clean the access port or stopcock above the roller clamp on the primary IV infusion tubing. 7. Connect piggyback setup to the access port or stopcock. If using, turn the stopcock to the open position. 8. Use strip of tape to secure secondary tubing to primary infusion tubing, if a needle is used to connect. 9. Open clamp on the secondary tubing. Use the roller clamp on the primary infusion tubing to regulate flow at the prescribed delivery rate or set rate for secondary infusion on infusion pump. Monitor medication infusion at periodic intervals. 10. Clamp tubing on piggyback set when solution is infused. Follow agency policy regarding disposal of equipment. 11. Replace primary IV fluid container to original height. Readjust flow rate of primary IV or check primary infusion rate on infusion pump.