Hanging an IV Piggyback

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Chance Reaves
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Included In This Lesson

Study Tools For Hanging an IV Piggyback

IV bags and tubing (Image)
140 Must Know Meds (Book)
Medication Administration Pro-Tips (Cheatsheet)
Spiking & Priming IV Bags (Cheatsheet)
Starting an IV (Cheatsheet)
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Outline

Overview

  1. Purpose
    1. Some IV infusions are hung as secondary, or piggyback, infusions with primary infusions of IV fluids
    2. This method ensures all of the medication is infused
    3. It also ensures the primary infusion is restarted immediately once the secondary is complete

Nursing Points

General

  1. Supplies needed to hang an IV piggyback
    1. Primary infusion – already spiked, primed, and infusing to patient
      1. Ensure fluids are compatible
    2. Secondary tubing
    3. Bag of med for piggyback infusion

Nursing Concepts

  1. Steps and Nursing Considerations
    1. Verify provider order
    2. ALWAYS follow 5 rights BEFORE preparing medication
      1. Right Patient
      2. Right Drug
      3. Right Dose
      4. Right Route
      5. Right Time
      6. Right Documentation
    3. ALWAYS prepare medications at the patient’s bedside
    4. Gather supplies
    5. Perform hand hygiene
    6. Don clean gloves
    7. Let the patient know what meds they will be receiving
    8. Remove IV med bag from package if applicable
    9. Open Secondary IV tubing package
    10. Clamp tubing with roller clamp
    11. Spike and prime the tubing appropriately
    12. Clamp tubing once fully primed
    13. Attach the secondary IV tubing to the port on the primary IV tubing that is above the pump
      1. Scrub the hub for 30 seconds with alcohol scrub
      2. Twist the leur-lock in place
    14. Set the pump for a secondary infusion per manufacturer instructions and according to the ordered rate
    15. Unclamp the secondary tubing , THEN Start Infusion
    16. AFTER administration
      1. Document administration
      2. If using barcode medication administration
        1. Scan all meds before preparing
        2. Confirm administration AFTER giving to patient
    17. Discard all used supplies
    18. Remove gloves
    19. Perform hand hygiene

Patient Education

  1. Indication and possible side effect(s) of medication(s)
  2. Signs to report to nurse or provider

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Transcript

In this video we’re going to look at how to hang an IV piggyback, otherwise known as a secondary IV infusion. To do this, you have to have a primary infusion running, so make sure you go back and watch how to spike and prime an IV infusion first!

So once you’ve verified your orders, you’re going to get your IV med bag out of the package if it’s in one.
Then you’ll open the secondary IV tubing package – this is usually much shorter than primary tubing and doesn’t go inside the pump. Then you’ll clamp that tubing once you have it open.

Then you need to spike and prime your secondary med bag – use a trashcan or the sink if you need to, then clamp it once it’s primed.

Now you’re going to attach the secondary IV tubing to the primary tubing – usually there’s a port above the pump, that’s where you want to attach it. Make sure you scrub the hub.

Now you can set the pump for a secondary infusion. If you aren’t sure how, check the manufacturer instructions or check with a charge nurse. Ad of course, make sure you’re setting it according to the ordered rate.

And, of course, make sure you unclamp the secondary tubing before you hit Start!

If you’re ever unsure how long to infuse these meds over, check with your pharmacist. Then, document the administration and monitor the patient for effects of the meds.

That’s it! Now, go out and be your best selves today. And, as always, happy nursing!

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Med-Surg Study Plan

Concepts Covered:

  • Shock
  • Cardiac Disorders
  • Vascular Disorders
  • Pregnancy Risks
  • Emergency Care of the Cardiac Patient
  • Medication Administration
  • Acute & Chronic Renal Disorders
  • Central Nervous System Disorders – Brain
  • Cardiovascular Disorders
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Postoperative Nursing
  • Intraoperative Nursing
  • Preoperative Nursing
  • Perioperative Nursing Roles
  • Circulatory System
  • Urinary System
  • Integumentary Disorders
  • Labor Complications
  • Eating Disorders
  • Respiratory System
  • Respiratory Disorders
  • Noninfectious Respiratory Disorder
  • Renal Disorders
  • Hematologic Disorders
  • Oncology Disorders
  • Immunological Disorders
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders
  • Neurological Trauma
  • Neurologic and Cognitive Disorders
  • Nervous System
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Emergency Care of the Neurological Patient
  • Neurological Emergencies

Study Plan Lessons

Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Hydralazine (Apresoline) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Losartan (Cozaar) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Warfarin (Coumadin) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Enoxaparin (Lovenox) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Digoxin (Lanoxin) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Atorvastatin (Lipitor) Nursing Considerations
Atenolol (Tenormin) Nursing Considerations
Amlodipine (Norvasc) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Hypoglycemia
Nursing Care and Pathophysiology for Hyperparathyroidism
Discharge (DC) Teaching After Surgery
Surgical Incisions & Drain Sites
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Intraoperative Nursing Priorities
Intraoperative (Intraop) Complications
Intraoperative Positioning
Sterile Field
Surgical Prep
Malignant Hyperthermia
Moderate Sedation
Local Anesthesia
General Anesthesia
Intubation in the OR
Preoperative (Preop) Nursing Priorities
Preoperative (Preop) Education
Preoperative (Preop)Assessment
Informed Consent
Perioperative Nursing Roles
Perioperative Nursing Course Introduction
Hypoparathyroidism
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Pressure Line Management
Hanging an IV Piggyback
Spiking & Priming IV Bags
IV Push Medications
Central Line Dressing Change
Drawing Blood
Starting an IV
Fluid & Electrolytes Course Introduction
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Hematology Module Intro
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Thrombocytopenia
Oncology Module Intro
Leukemia
Lymphoma
Oncology Important Points
Immunology Module Intro
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Lyme Disease
Systemic Lupus Erythematosus (SLE)
Metabolic & Endocrine Module Intro
Addisons Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Diabetes Mellitus (DM) Module Intro
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Diabetes Management
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Respiratory Course Introduction
Respiratory A&P Module Intro
Lung Sounds
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Oxygen Delivery Module Intro
Hierarchy of O2 Delivery
Artificial Airways
Airway Suctioning
Blunt Chest Trauma
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Chest Tube Management
Respiratory Procedures Module Intro
Bronchoscopy
Thoracentesis
Neuro A&P Module Intro
Neuro Anatomy
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Neuro Assessment Module Intro
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Cerebral Perfusion Pressure CPP
Neuro Disorders Module Intro
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Brain Tumors
Encephalopathies
Miscellaneous Nerve Disorders
Stroke (CVA) Module Intro
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Cardiovascular Disorders (CVD) Module Intro
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Cardiac Course Introduction
HMG-CoA Reductase Inhibitors (Statins)
Cardiac Glycosides
Calcium Channel Blockers
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System