Giving Medication Through An IV Set Port

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Chance Reaves
MSN-Ed,RN
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Included In This Lesson

Study Tools For Giving Medication Through An IV Set Port

IV Therapy (Cheatsheet)
Spiking & Priming IV Bags (Cheatsheet)
Starting an IV (Cheatsheet)
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Outline

Overview

Medications that are given IV should be given through one of three IV ports:

  1. Port above the safety clamp
  2. Port below safety clamp (middle port)
  3. Port closest to patient

Nursing Points

General

  1. Port above safety clamp
    1. Slow intermittent infusions the pump must regulate
      1. Piggybacks
        1. Antibiotics
        2. Anti-emetic infusions
        3. Electrolytes
        4. Volumes of typically 100-250 mL
  2. Port below safety clamp (middle port)
    1. Intermittent infusions that can be given via gravity
    2. Not regulated by the IV pump
      1. Albumin
      2. Certain blood products
        1. Check facility policy
  3. Port closest to the patient
    1. IV medications that are delivered directly to the patient in small doses
      1. Pain medications
      2. Anti-emetics
      3. Blood pressure medications
  4. Pro-Tips
    1. Think Safety
      1. Any drug that needs to be tightly regulated should go through a pump
      2. For titrated drugs, they should have a dedicated channel
    2. Be a steward of your patient
      1. Don’t waste product
        1. If a medication can be safely given via gravity, then use the middle port
        2. Don’t set up an entire line if the medication can be piggybacked
        3. Don’t set up an entire line if a medication dosage amount should be given slowly through another port
          1. Example: Metoprolol
            1. Should be given in the IV port closest to the patient
            2. Requires constant assessment during administration
            3. Don’t infuse through a piggyback

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Transcript

Okay guys, in this lesson we’re going to take a really close look at all of the IV ports on our primary set. Now some primary sets come with two ports or Y sites or they’ll come with three. This particular one has two and we’re going to talk about two but we’re also going to talk about the third really intensely. It’s really important to note that these ports have a really specific function. What they do is allow medications or different devices like other IV lines to be hooked up to them and to have infusions or medications given to them. So it’s like a lure lock system you put it on and you can give it. If this, if this is a medication, I can just give it directly into the line. Now the important thing that you need to realize that this safety clamp is a safety feature and it runs through the pump.

So when you’re looking at medications that go through this top port or Y site, you have to think about how it’s used. If it’s going to go in here, it needs to be regulated by the pump. So if you have a medication that needs to be regulated by a pump, so these are things like antibiotics or even electrolytes, you have to pro, you have to program it inside this module, then it needs to go in this port. It’s so important you will hang a piggyback, but that’s what that particular port is used for. Now in this set is one that goes closest to the patient. This is where you can have some intermittent infusions going, but it’s really, really helpful if you have to give your patient IV push medication like Zofran or even pain medications like Dilaudid or morphine. This is a great, because it’s so close to the patient, it’s important to use this port specifically for these medications because you can give it and then flush.

What you don’t want to do is put it higher in the line and then if the line goes bad, you have all of the medication that was wasted and then you have to go back and go get more narcotics or you have to waste that medication and then the patient doesn’t get it and you don’t know exactly how much they got. So it’s always best to go closest to the patient and you can give just a flush so you know how much went down. Now the third port that’s really important, and it’s not on this line, but it is important for you to know about if you have it is used for intermittent medications that are not regulated by the pump. That’s the biggest difference between the one above the pump and below the pump. If it’s got to be regulated by the pump.

If it’s a drip and antibiotics, something like that has to go above the pump. But if it can go to gravity or it can be regulated by its own little flow meter, that will work great in the middle. Why site? So just know that if you have a medication that can go in the line, it’s compatible with all of the other drugs, just make sure that you’re aware that that middle one can actually be used for gravitational medications or medications that have their own little flow meter. Now a couple of pro tips. If you have a medication that needs to be titrated, it’s best put on its own dedicated channel. Titrating drips on a secondary kind of as a piggyback is not necessarily the safest thing and a lot of times isn’t even allowed by their pumps. So if you have a medication that needs to be titrated, especially for those high acuity patients, put them in their own specific channel. They second thing that I want to talk to you about is being a steward of your patient. Just because we have medication supplies readily at our disposal doesn’t mean that they’re not expensive and that they don’t impact your patient. Always be cautious of that. If a medication can be piggybacked, don’t dedicate an entire channel or an entire line instead of supplies to that.

Now go out and be your best selves today. And as always, happy nursing.

 

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Nursing Clinical 360

With the rapid expansion of the COVID-19 pandemic many schools, instructors and students are left wondering what just happened?Students can’t access the tools and onsite clinical help they desperately need and instructors are trying to piece together online learning that prepares their students for success.It is because of this uncertainty and abrupt change that we have developed the Nursing Clinical 360 Course.Featuring:38 Highly Detailed Nursing Skills Video Lessons18 Health Assessment Lessons26 IV Skills Videos42 Case Studies30+ Care PlansWe want to give students the practical knowledge they need to feel confident going into a clinical or practical situation, as well as give instructors a concise library of online resources to handle the sudden demand for distance learning.

Course Lessons

1 - Head to Toe and Health Assessment
Intro to Health Assessment
Barriers to Health Assessment
The 5-Minute Assessment (Physical assessment)
Adult Vital Signs (VS)
Pediatric Vital Signs (VS)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
2 - IV Insertion
Supplies Needed
Using Aseptic Technique
Selecting THE vein
Tips & Tricks
IV Catheter Selection (gauge, color)
IV Insertion Angle
How to Secure an IV (chevron, transparent dressing)
Drawing Blood from the IV
Maintenance of the IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Needle Safety
IV Drip Therapy – Medications Used for Drips
IV Drip Administration & Safety Checks
Understanding All The IV Set Ports
Giving Medication Through An IV Set Port
How to Remove (discontinue) an IV
IV Placement Start To Finish (How to Start an IV)
Bariatric: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Combative: IV Insertion
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
3- Nursing Skills
Nursing Skills (Clinical) Safety Video
Bed Bath
Linen Change
PPE Donning & Doffing
Sterile Gloves
Mobility & Assistive Devices
Spinal Precautions & Log Rolling
Restraints
Starting an IV
Drawing Blood
Blood Cultures
Central Line Dressing Change
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Trach Suctioning
Trach Care
Inserting an NG (Nasogastric) Tube
NG (Nasogastric)Tube Management
NG Tube Med Administration (Nasogastric)
Stoma Care (Colostomy bag)
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Pill Crushing & Cutting
EENT Medications
Topical Medications
Drawing Up Meds
Medications in Ampules
Insulin Mixing
SubQ Injections
IM Injections
IV Push Medications
Spiking & Priming IV Bags
Hanging an IV Piggyback
Chest Tube Management
Pressure Line Management
4- Nursing Care Plans
Purpose of Nursing Care Plans
How to Write a Nursing Care Plan
Using Nursing Care Plans in Clinicals
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
Nursing Care Plan (NCP) for Alzheimer’s Disease
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Aortic Aneurysm
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Arterial Disorders
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan for Cirrhosis (Liver)
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Leukemia
Nursing Care Plan (NCP) for Mood Disorders (Major Depressive Disorder, Bipolar Disorder)
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Neutropenia
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Parkinson’s Disease
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Schizophrenia
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
Nursing Care Plan (NCP) for Thrombocytopenia
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Post-Traumatic Stress Disorder (PTSD)
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia
Nursing Care Plan (NCP) for Renal Calculi
5- Nursing Concept Maps
Concept Map Course Introduction
Coronary Artery Disease Concept Map
COPD Concept Map
Asthma Concept Map
Pneumonia Concept Map
Bowel Obstruction Concept Map
Gastrointestinal (GI) Bleed Concept Map
Congestive Heart Failure Concept Map
Hypertension (HTN) Concept Map
Breast Cancer Concept Map
Amputation Concept Map
Sepsis Concept Map
Stroke Concept Map
Depression Concept Map