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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Basics of Pharm Study Plan

Concepts Covered:

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

Study Plan Lessons

Pharmacology Course Introduction
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
12 Points to Answering Pharmacology Questions
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
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
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Complex Calculations (Dosage Calculations/Med Math)
Pediatric Dosage Calculations
Struggling with Dimensional Analysis? – Live Tutoring Archive
Medication Errors
6 Rights of Medication Administration
Using Aseptic Technique
Supplies Needed
Needle Safety
Drawing Up Meds
Medications in Ampules
Oral Medications
SubQ Injections
IM Injections
Injectable Medications
Pill Crushing & Cutting
Positioning
Tips & Tricks
Insulin
Insulin Mixing
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin Drips
Glipizide (Glucotrol) Nursing Considerations
IV Insertion Course Introduction
Selecting THE vein
IV Catheter Selection (gauge, color)
IV Insertion Angle
Starting an IV
IV Placement Start To Finish (How to Start an IV)
Bariatric: IV Insertion
Combative: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Tips & Advice for Pediatric IV
Tips & Advice for Newborns (Neonatal IV Insertion)
How to Secure an IV (chevron, transparent dressing)
Maintenance of the IV
How to Remove (discontinue) an IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Understanding All The IV Set Ports
Spiking & Priming IV Bags
IV Infusions (Solutions)
Hanging an IV Piggyback
Giving Medication Through An IV Set Port
IV Push Medications
IV Pump Management
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
Drawing Blood from the IV
NG Tube Medication Administration
NG Tube Med Administration (Nasogastric)
Interactive Practice Drip Calculations
Pain Management Meds – Live Tutoring Archive
Pain Management for the Older Adult – Live Tutoring Archive
Opioid Analgesics in Pregnancy
Patient Controlled Analgesia (PCA)
Codeine (Paveral) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
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ACLS (Advanced cardiac life support) Drugs
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Amiodarone (Pacerone) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Hydralazine
Lidocaine (Xylocaine) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Nitro Compounds
Verapamil (Calan) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
TCAs
MAOIs
Mood Stabilizers
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Anti-Infective – Antifungals
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Cefdinir (Omnicef) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
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Mannitol (Osmitrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Epoetin Alfa
Neostigmine (Prostigmin) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Meds for Postpartum Hemorrhage (PPH)
Methylergonovine (Methergine) Nursing Considerations
Rh Immune Globulin in Pregnancy
Eye Prophylaxis for Newborn
Phytonadione (Vitamin K) for Newborn
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Anesthetic Agents
Propofol (Diprivan) Nursing Considerations
Nalbuphine (Nubain) Nursing Considerations
Interactive Pharmacology Practice