Giving Medication Through An IV Set Port

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Chance Reaves
MSN-Ed,RN
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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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NP4 exam1

Concepts Covered:

  • Circulatory System
  • Urinary System
  • Noninfectious Respiratory Disorder
  • Respiratory System
  • Integumentary Disorders
  • Respiratory Disorders
  • Labor Complications
  • Disorders of Pancreas
  • Pregnancy Risks
  • Cardiac Disorders
  • Eating Disorders
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Shock
  • Medication Administration
  • Upper GI Disorders
  • Fundamentals of Emergency Nursing
  • Understanding Society
  • Adulthood Growth and Development
  • Oncologic Disorders
  • Postoperative Nursing
  • Renal Disorders
  • Microbiology
  • Intraoperative Nursing
  • Shock
  • Tissues and Glands
  • Newborn Care

Study Plan Lessons

EKG (ECG) Course Introduction
Fluid & Electrolytes Course Introduction
Respiratory Course Introduction
Electrical A&P of the Heart
Respiratory A&P Module Intro
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid Pressures
Lung Sounds
Alveoli & Atelectasis
Alveoli & Atelectasis
Fluid Shifts (Ascites) (Pleural Effusion)
Gas Exchange
Gas Exchange
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Lung Diseases Module Intro
The EKG (ECG) Graph
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Asthma
EKG (ECG) Waveforms
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Calculating Heart Rate
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Phosphorus-Phos
Normal Sinus Rhythm
Normal Sinus Rhythm
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Influenza (Flu)
Sinus Bradycardia
Sinus Bradycardia
Sinus Tachycardia
Sinus Tachycardia
Nursing Care and Pathophysiology for Tuberculosis (TB)
Atrial Flutter
Pacemakers
Nursing Care and Pathophysiology of Pneumonia
Atrial Fibrillation (A Fib)
Atrial Fibrillation (A Fib)
Coronavirus (COVID-19) Nursing Care and General Information
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Oxygen Delivery Module Intro
Hierarchy of O2 Delivery
Nursing Care and Pathophysiology of Hypertension (HTN)
Artificial Airways
Artificial Airways
Airway Suctioning
Airway Suctioning
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Respiratory Trauma Module Intro
Blunt Chest Trauma
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Chest Tube Management
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Pulmonary Embolism
Respiratory Procedures Module Intro
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acute Coronary Syndrome (ACS) Module Intro
Bariatric: IV Insertion
Base Excess & Deficit
Blood Flow Through The Heart
Bronchoscopy
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Course Introduction
Cardiovascular Disorders (CVD) Module Intro
Chest Tube Management
Combative: IV Insertion
Coronary Circulation
Dark Skin: IV Insertion
Drawing Blood from the IV
Fluid Compartments
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
Hemodynamics
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
Lactic Acid
Lung Sounds
Maintenance of the IV
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
MI Surgical Intervention
Needle Safety
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Pneumonia
Pacemakers
Performing Cardiac (Heart) Monitoring
Positioning
Potassium-K (Hyperkalemia, Hypokalemia)
Preload and Afterload
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Selecting THE vein
Shock Module Intro
Supplies Needed
Tattoos IV Insertion
Thoracentesis
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms