Overview

1. Purpose
   1. In order to administer IV fluids, tubing needs to be attached to the fluid bag.
   2. This process is called “spiking and priming”
   3. It should be done carefully to avoid piercing the bag or getting air bubbles in the tubing.

Nursing Points

General

1. Supplies needed
   1. Bag of fluids
   2. Primary tubing
   3. IV Pole
   4. IV Pump

Nursing Concepts

1. Steps and Nursing Considerations
   1. Verify provider order
   2. ALWAYS follow 5 rights BEFORE preparing medication
      1. Right Patient
      2. Right Drug
      3. Right Dose
      4. Right Route
      5. Right Time
   3. ALWAYS prepare medications at the patient’s bedside
   4. Gather supplies
   5. Perform hand hygiene
   6. Don clean gloves
   7. Let the patient know what fluids they will be receiving
   8. Remove IV fluid bag from package if applicable
   9. Open IV tubing package
   10. Clamp tubing with roller clamp
       1. If it has multiple clamps, make sure all are open except the roller
   11. Invert the IV fluid bag and remove stopper from port
   12. Remove the cover from the spike on the IV tubing
   13. Insert the spike into the port on the bag
       1. Push and twist
       2. Straight in to avoid puncturing bag
   14. Turn the bag right-side up and hang on an IV pole
   15. Squeeze the drop chamber so it’s ½ full
   16. Slowly unclamp the roller clamp until the fluid starts flowing
   17. Use the roller clamp to control the flow until the tubing is full of the IV fluid
       1. Remove ALL air bubbles
       2. Prime over a sink or trashcan
       3. Not too quickly or air bubbles will form in tubing
   18. Clamp tubing once fully primed
   19. Attach the tubing to the patient’s IV access
       1. Scrub the hub for 30 seconds with alcohol scrub
       2. Twist the leur-lock in place
   20. Insert the tubing into your IV pump and program appropriately according to your orders
   21. AFTER administration
       1. Document administration
       2. If using barcode medication administration
          1. Scan all meds before preparing
          2. Confirm administration AFTER giving to patient
   22. Discard all used supplies
   23. Remove gloves
   24. Perform hand hygiene

Patient Education

1. Indication and possible side effect(s) of medication(s)
2. Signs to report to nurse or provider