IV Drip Administration & Safety Checks

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Chance Reaves
MSN-Ed,RN
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Outline

Nursing Points

General

  1. Verify order on Medication Administration Record
    1. Check all aspects of the formulation
      1. Drug amount
      2. Volume of fluid to be infused
      3. Concentration
    2. Verify medication with 6 patient rights
      1. Also verify need for medication and condition
  2. Equipment safety
    1. Correct Tubing
    2. Does the pump allow for this medication
      1. Ensure that the pump programmable for a particular medication
      2. Safety verification (mcg/kg/min vs mg/hr vs mL/hr)
      3. Use the correct tubing
  3. Patient safety
    1. Verify if venous access is appropriate for the type of medication
      1. Certain medications cannot be infused in peripheral IVs
        1. Example: Vasopressors can cause extravasation, but if no central line is available PIVs can be used
          1. Check facility policy
    2. Set alarms and safeguards appropriately
      1. BP alarms (A-Line or NIBP) should be set for MAR parameters
        1. Have provider place order for parameters
      2. IV Pumps should have safeguards that force a reassessment
        1. Think, “Is this really what should be done?”

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Transcript

Okay guys, in this lesson we’re going to talk about drip calculation and safety checks when it comes to IV drips. So the first thing that you want to do even when you’re getting a new drip on a patient is you want to familiarize yourself with that patient’s new drug. So you need to look at the type of medication it is, what it’s used for, its indication. You want to check everything out, especially if you’re not familiar with it. If you’re not, grab one of your colleagues and make sure that you know exactly what you’re doing with that medication. We’ll go over a few other safety, a few important safety features of these pumps a little bit later, but right now what you need to focus on is why your patient needs him. The other thing you want to do is always verify against the six patient rights.

You want to make sure that all of the six patient RIGHTs are followed, including that, right? Giving the right medication for that and make sure that you’re giving the right medication for that patient. Now let’s talk about some of the important features of the drip. First off is the correct tubing. Anytime you give a medication, you’re going to have some sort of tubing that goes into it. Not all medications are compatible with all types of tubing and you have to talk to the pharmacy or follow a facility policy. Some medications need filters, some medications need particular types of tubing. Some can’t even go to these pumps, so it’s really important, especially if you’re giving high acuity patients, different types of drips that you’re falling, all the necessary manufacturer protocols and all the pharmacological form protocols. The other thing that we need to think about is the feature of the pump itself.

There are a lot of cool safety features built in, but they are necessary. When you’re thinking about safety, you need to make sure can this unit even handle it. There are some really important program features inside the pump that help you select different units and different drugs. In addition, some of these pumps can even program down to the correct mil per minute that you need for patients and that’s an awesome safety feature. The last thing that we want to consider anytime we’re giving a drip is patient safety. Not all medications are going to be safe given in peripheral IVs and so sometimes we have to get central access. Given our options. In some situations, peripheral IVs are our only option and if that’s the difference between life and death for the patient, we’re going to make sure we’re going to do our best to make sure that we’re doing everything we can for that patient. 

So always make sure that you have the right access. Even though you’re giving a drip that and you have an peripheral IV access, sometimes it’s just not appropriate. The last thing we want to talk about patient safety is setting alarms. There are alarms built into the pump, but they’re more built for safeguards. They want to say, Hey, this drug may be too high for this patient or too much for this weight range. There are safety features built-in, but the other thing you want to consider is if you’re giving a drug that’s going to act on the cardiovascular system, like let’s say you have a patient who’s hypotensive and you need to get those pressures up, you also need to set your bedside alarms to make sure they’re going off and keep those turret parameters really tight so that anytime that alarm goes off, even if you step away just outside of the room for second to gram one thing and you think your blood pressure and being controlled for 12 hours, all of a sudden that pressure drops. You can go in there and make the change because you’ve had those title alarms set. Technology has come a long way in helping us develop new safety features, including safety features in the pump and safety features on the monitors. Don’t let that dissuade you from doing everything that you need to do from a nursing standpoint to make sure that you’re being critical of all of the safety features that you need to go into safe practice. Now go out and be your best selves today. And as always, happy nursing.

 

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Week 1 Self Study Oct 2-9 Nursing Clinical 360

Concepts Covered:

  • Labor Complications
  • Newborn Complications
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Oncology Disorders
  • EENT Disorders
  • Cardiac Disorders
  • Respiratory Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Medication Administration
  • Upper GI Disorders
  • Understanding Society
  • Tissues and Glands
  • Adulthood Growth and Development
  • Fundamentals of Emergency Nursing
  • Newborn Care
  • Intraoperative Nursing
  • Circulatory System
  • Postoperative Nursing
  • Microbiology
  • Respiratory Emergencies
  • Central Nervous System Disorders – Brain
  • Liver & Gallbladder Disorders
  • Musculoskeletal Disorders
  • EENT Disorders
  • Legal and Ethical Issues
  • Integumentary Disorders
  • Neurological Trauma
  • Pregnancy Risks
  • Postpartum Complications
  • Urinary Disorders
  • Urinary System
  • Noninfectious Respiratory Disorder
  • Respiratory System

Study Plan Lessons

Adult Vital Signs (VS)
Pediatric Vital Signs (VS)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
Bariatric: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Combative: IV Insertion
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Supplies Needed
Using Aseptic Technique
Selecting THE vein
Tips & Tricks
IV Catheter Selection (gauge, color)
IV Insertion Angle
How to Secure an IV (chevron, transparent dressing)
Drawing Blood from the IV
Giving Medication Through An IV Set Port
How to Remove (discontinue) an IV
IV Placement Start To Finish (How to Start an IV)
Maintenance of the IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Needle Safety
IV Drip Therapy – Medications Used for Drips
IV Drip Administration & Safety Checks
Understanding All The IV Set Ports
IV Push Medications
Spiking & Priming IV Bags
Chest Tube Management
Pressure Line Management
Drawing Up Meds
Insulin Mixing
SubQ Injections
IM Injections
Hanging an IV Piggyback
NG (Nasogastric)Tube Management
NG Tube Med Administration (Nasogastric)
Stoma Care (Colostomy bag)
Wound Care – Assessment
Wound Care – Selecting a Dressing
Wound Care – Dressing Change
Wound Care – Wound Drains
Pill Crushing & Cutting
EENT Medications
Topical Medications
Medications in Ampules
Nursing Skills (Clinical) Safety Video
PPE Donning & Doffing
Sterile Gloves
Mobility & Assistive Devices
Spinal Precautions & Log Rolling
Restraints
Starting an IV
Drawing Blood
Blood Cultures
Central Line Dressing Change
Inserting a Foley (Urinary Catheter) – Female
Inserting a Foley (Urinary Catheter) – Male
Trach Suctioning
Trach Care
Inserting an NG (Nasogastric) Tube