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IV Therapy IVPB IVP Administration of IV Medications ‡ What are the 3 types of IV administration you will do? ² Saline Flush ² IV Piggy Back ² IV Push medication ‡ How often do you flush a saline lock? ² Once a shift ‡ How many ways can you give an IV Piggy Back? ² Primary Line ² Secondary Line ‡ How many ways to give IV Push? ² Saline Lock ² Primary Line ² Tri-lumen Tri- Administration of IV Medications ‡ Saline Locks ‡ Intravenous Piggy Back ‡ Intravenous Push Medications Administration of IV Medications ‡ Saline Lock ² Hospital policy ² Done to check and maintain patency ² Usually ordered once per shift ² Always done prior to giving any medications ² Site changed every 72 hours/policy Saline Lock ‡ Procedure ² Check Dr.·s order/MAR for frequency ² Draw up 2cc saline ‡ Needless system ² Check patient·s ID ² Check site for ‡ ‡ ‡ ‡ Swelling Redness Pain Temperature ‡ Gloves do not have to be worn unless potential for blood contact ‡ Connect syringe to adapter ‡ Aspirate back gently ² If blood return, very gently try to inject saline, if flows easily continue, watch site for swelling or pain ‡ If resistance, stop and reassess ² Reposition arm and gently manipulate site ² Attempt to aspirate again ² If blood return, continue procedure ² If no blood return, again attempt to inject saline ‡ DO NOT try to push against resistance ‡ Restart the site Saline Lock ‡ Never give any medication through a saline lock without checking patency ‡ Check patency at least once per shift Intravenous Piggy Back Medications ‡ Purpose ² To administer intermittent IV drugs that cannot be mixed with the primary solution ² To administer different IV drugs at different times ² To maintain peak levels of a medication in the blood stream Intravenous Piggy Back Medications ‡ Review hospital policy ‡ Check Dr.·s orders and confirm compatibility of medication (if IV running) ‡ Assess site ‡ Determine if to be given ² Primary line ² Secondary line Intravenous Piggy Back Medications ‡ Secondary line ² Check compatibility with IV running ‡ If incompatible, will need to flush with saline before/after ² Obtain Secondary set/ clamp tubing ² Check type of container for medication ‡ Bottle ‡ Additive bag ‡ IV bag Intravenous Piggy Back Medications ‡ Secondary line ² ² ² ² ² ² ² ² ² Spike container Fill chamber Prime tubing Connect to IV pump or primary line Unclamp tubing Set rate on pump or manually time Monitor administration of medication Ensure all medication is administered Document on MAR Intravenous Piggy Back Medications ‡ Primary line to saline lock ² Obtain primary tubing ‡ Determine amount of fluid to prime tubing ² Clamp tubing ² Spike medication container ² Fill chamber ² Prime tubing Intravenous Piggy Back Medications ² Flush saline lock (2cc saline) ² Connect medication tubing ‡ IV pump ‡ Gravity ² Monitor administration/complete infusion ² Flush saline lock with enough saline to give all medication ² Document on MAR Intravenous Push Medications ‡ Purpose ² To achieve immediate and maximum effects of a medication ‡ Always check medication with IV drug book Intravenous Push Medications ‡ Assessment focus ² Patency/signs of infiltration or infection at site ² Base line vital signs ² Allergies ² Compatibility of medication and IV fluid ² Normal dose/rate/dilution ² Specific drug action ² Side effects ² Time of peak action Intravenous Push Medications ‡ Procedure ² Check Dr.·s order/MAR/IV Drug book ² Determine method to give ‡ Primary line ‡ Saline lock ² Collect equipment ‡ ‡ ‡ ‡ Correct medication Correct size syringe Alcohol swabs Appropriate additional supplies if needed Intravenous Push Medications ‡ Prepare medication/ FIVE RIGHTS ‡ Saline flush(s) ‡ Maintain aseptic technique Intravenous Push Medications ‡ Primary line ² ² ² ² ² ² ² ² Check compatibility with fluid infusing Connect needless port Stop IV infusion if rate fast Give medication through needless port: FIVE RIGHTS Flush port with saline Restart IV if needed Assess patient Document on MAR Intravenous Push Medications ‡ Primary line when medication is incompatible ² Stop infusion ² Clamp above port to be used ² Flush line with enough saline to clear line ² Administer medication ² Flush line post medication ² Restart infusion Intravenous Push Medications ‡ Saline lock ² Prepare medication and two saline flushes (2cc each) ² Check patency of line with saline flush ² Administer medication ² FIVE RIGHTS ² Flush line with 2 cc·s saline ² Assess patient ² Document on MAR