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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Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Anatomy of an NCLEX Question
Diagnostics Terminology
Head to Toe Nursing Assessment (Physical Exam)
How to Take Nursing Report
How to Write A Nursing Progress Note
Intro to Community Health
Lung Sounds
MedTerm Suffixes
Nursing Process
Nursing Process – Assess
Nursing Process – Diagnose
Nursing Process – Evaluate
Nursing Process – Implement
Nursing Process – Plan
Nutrition (Diet) in Disease
Overview of the Nursing Process
Head to Toe Nursing Assessment (Physical Exam)
10.02 Breath Sounds for CCRN Review
Heart (Cardiac) Sound Locations and Auscultation
Heart (Cardiac) and Great Vessels Assessment
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Lung Sounds
Biohazard Material Handling and Disposition (Blood, Microbiology, Creutzfeldt-Jakob Disease) for Certified Perioperative Nurse (CNOR)
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Sterile Field
Sterile Gloves
Sterile Field Maintenance (Aseptic Technique) for Certified Perioperative Nurse (CNOR)
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Sterilization and Storage Environment Conditions for Certified Perioperative Nurse (CNOR)
Transportation and Storage (Single Use Items) for Certified Perioperative Nurse (CNOR)
Using Aseptic Technique
Wound Care – Assessment
Wound Care – Dressing Change
Wound Care – Wound Drains
Complex Calculations (Dosage Calculations/Med Math)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
ABGs Nursing Normal Lab Values
Albumin Lab Values
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Blood Plasma
Bowel Obstruction Concept Map
C. Difficile for Certified Emergency Nursing (CEN)
Dehydration
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid & Electrolytes Course Introduction
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
Fluid Volume Overload
Formation & Excretion of Urine
Giving Medication Through An IV Set Port
Heart (Cardiac) Failure Therapeutic Management
Heat Temperature-related Emergencies for Certified Emergency Nursing (CEN)
12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
ACE (angiotensin-converting enzyme) Inhibitors
ACLS (Advanced cardiac life support) Drugs
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
6 Rights of Medication Administration
Drawing Up Meds
EENT Medications
Ethical Dilemmas for Certified Emergency Nursing (CEN)
Hanging an IV Piggyback
Insulin Mixing
IM Injections
IV Drip Administration & Safety Checks
IV Push Medications
Medication Errors
Medications in Ampules
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nursing Case Study for Mania (Manic Syndrome)
Pill Crushing & Cutting
Safety Checks
Spiking & Priming IV Bags
SubQ Injections
Topical Medications
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
ACLS (Advanced cardiac life support) Drugs
C – Content
Epinephrine (EpiPen) Nursing Considerations
Nursing Care Plan (NCP) for Angina
Renin Angiotensin Aldosterone System
Renin Angiotensin Aldosterone System (RAAS)
Artificial Airways
Hierarchy of O2 Delivery
Oxygen Delivery Module Intro
54 Common Medication Prefixes and Suffixes