Transcript Some terminology:

Terminology
• Piggyback: general term meaning ‘attach 1
tubing to another’
• Continuous vs Intermittent
• Secondary Tubing
• Y-site
• Volume Controlled set
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Advantages IV route
• Direct (and instant) access to circulatory
system
• Able to give drugs too irritating for gastric
mucosa – or for delivering high concentrations
• Since IVPB (“intermittent”) usually over 30 –
60 min, can instantly d/c if reaction occurs
• Able to give meds when GI tract not available
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Disadvantages of IV route
• Drug interactions because of incompatibilities
• Sometimes drug absorbed by plastic
container – full dose not delivered
• Speed shock
• Tissue injury – chemical phlebitis or when
certain drugs infiltrate
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Before hanging med:
• Check expiration date on secondary
tubing.
• Does tubing have sterile cap?
• 5 rights, plus
– rate of administration
– compatibility of IV solution
• clean access (Y-site) ports with alcohol
prior to each access.
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Compatibility & Rate of Administration
Drug books
• Davis’s Drug Guide: each drug divided into
sections; find “IV Administration” section
– “intermittent administration” & compatibility
• Gahart: information under Dilution, Rate of
Administration, Compatibility
– Intermittent IV (vs IV injection or infusion)
• Pharmacy
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Ondansetron HCL (Zofran)
(Gahart & Nazareno, Intravenous Medications)
Dilution
• IV injection:…
• Intermittent infusion: single dose should be diluted in
50 mL of NS or D5W. Also available…
Compatibility
• Additive
• Y-site
Rate of Administration
• IV injection…
• Intermittent infusion: single dose over 15 min.
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Primary IV on Infuser pump
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•
•
•
•
Y-site above the pump (‘rate controller’)
Backprime
“piggyback” or “secondary” function key
Rate
VTBI
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Primary IV to gravity
Dial-a-flow or stat-master = the ‘rate controller’
• Y-site above rate controller
• Set at desired ml/hr AND check gtts/min to
verify accuracy.
Maintenance solution stops while infusing an
intermittent med attached above the pump or
dial-a flow
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After hanging med
• Make sure it is infusing
– Have you opened the clamp?
• Check on pt after 5-10 min
• 6th right: document
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Syringe Pump
• “spaghetti” tubing
• Note where flange of syringe goes
• Attach closest to IV insertion site (below the
‘rate controller’)
• Maintenance solution does not stop
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Saline Lock
• Saline
• Administer med
• Saline
• Used with Syringe pump, gravity tubing, or EID
What if solution is incompatible?
• Use Primary tubing and connect to
lower Y-site
– Turn off primary IV
– Flush with saline before and after
or
• Disconnect primary IV, hang NS and
use secondary tubing.
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