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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Pharmacology

Concepts Covered:

  • Medication Administration
  • Adult
  • Emergency Care of the Cardiac Patient
  • Intraoperative Nursing
  • Microbiology
  • Cardiac Disorders
  • Anxiety Disorders
  • Depressive Disorders
  • Vascular Disorders
  • Nervous System
  • Upper GI Disorders
  • Central Nervous System Disorders – Brain
  • Gastrointestinal Disorders
  • Immunological Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Understanding Society
  • Circulatory System
  • Concepts of Pharmacology
  • Studying
  • Hematologic Disorders
  • Newborn Care
  • Adulthood Growth and Development
  • Disorders of Pancreas
  • Respiratory Disorders
  • Postoperative Nursing
  • Pregnancy Risks
  • Neurological
  • Postpartum Complications
  • Substance Abuse Disorders
  • Noninfectious Respiratory Disorder
  • Bipolar Disorders
  • Peripheral Nervous System Disorders
  • Learning Pharmacology
  • Psychotic Disorders
  • Prenatal Concepts
  • Tissues and Glands
  • Test Taking Strategies

Study Plan Lessons

6 Rights of Medication Administration
ACLS (Advanced cardiac life support) Drugs
Adenosine (Adenocard) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Anesthetic Agents
Anti-Infective – Antifungals
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Bariatric: IV Insertion
Basics of Calculations
Benztropine (Cogentin) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Epoetin Alfa
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
IM Injections
Injectable Medications
Insulin
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
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 Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
12 Points to Answering Pharmacology Questions