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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NP4 exam1

Concepts Covered:

  • Circulatory System
  • Urinary System
  • Noninfectious Respiratory Disorder
  • Respiratory System
  • Integumentary Disorders
  • Respiratory Disorders
  • Labor Complications
  • Disorders of Pancreas
  • Pregnancy Risks
  • Cardiac Disorders
  • Eating Disorders
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Shock
  • Medication Administration
  • Upper GI Disorders
  • Fundamentals of Emergency Nursing
  • Understanding Society
  • Adulthood Growth and Development
  • Oncologic Disorders
  • Postoperative Nursing
  • Renal Disorders
  • Microbiology
  • Intraoperative Nursing
  • Shock
  • Tissues and Glands
  • Newborn Care

Study Plan Lessons

EKG (ECG) Course Introduction
Fluid & Electrolytes Course Introduction
Respiratory Course Introduction
Electrical A&P of the Heart
Respiratory A&P Module Intro
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid Pressures
Lung Sounds
Alveoli & Atelectasis
Alveoli & Atelectasis
Fluid Shifts (Ascites) (Pleural Effusion)
Gas Exchange
Gas Exchange
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Lung Diseases Module Intro
The EKG (ECG) Graph
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Asthma
EKG (ECG) Waveforms
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Calculating Heart Rate
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Phosphorus-Phos
Normal Sinus Rhythm
Normal Sinus Rhythm
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Influenza (Flu)
Sinus Bradycardia
Sinus Bradycardia
Sinus Tachycardia
Sinus Tachycardia
Nursing Care and Pathophysiology for Tuberculosis (TB)
Atrial Flutter
Pacemakers
Nursing Care and Pathophysiology of Pneumonia
Atrial Fibrillation (A Fib)
Atrial Fibrillation (A Fib)
Coronavirus (COVID-19) Nursing Care and General Information
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Oxygen Delivery Module Intro
Hierarchy of O2 Delivery
Nursing Care and Pathophysiology of Hypertension (HTN)
Artificial Airways
Artificial Airways
Airway Suctioning
Airway Suctioning
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Respiratory Trauma Module Intro
Blunt Chest Trauma
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Chest Tube Management
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Pulmonary Embolism
Respiratory Procedures Module Intro
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acute Coronary Syndrome (ACS) Module Intro
Bariatric: IV Insertion
Base Excess & Deficit
Blood Flow Through The Heart
Bronchoscopy
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Course Introduction
Cardiovascular Disorders (CVD) Module Intro
Chest Tube Management
Combative: IV Insertion
Coronary Circulation
Dark Skin: IV Insertion
Drawing Blood from the IV
Fluid Compartments
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
Hemodynamics
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
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 Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
Lactic Acid
Lung Sounds
Maintenance of the IV
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
MI Surgical Intervention
Needle Safety
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Pneumonia
Pacemakers
Performing Cardiac (Heart) Monitoring
Positioning
Potassium-K (Hyperkalemia, Hypokalemia)
Preload and Afterload
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Selecting THE vein
Shock Module Intro
Supplies Needed
Tattoos IV Insertion
Thoracentesis
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms