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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Pharmacology

Concepts Covered:

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

Study Plan Lessons

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