Transcript Intravenous Medication Administration

Fundamental Nursing
Chapter 35
Intravenous Medications
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The
intravenous
(IV)
route
(drug
administration through peripheral and central
veins) provides an immediate effect.
Consequently, this route of drug administration
is the most dangerous. Drugs given in this
manner cannot be retrieved once they have
been delivered.
For this reason, only specially qualified nurses
are permitted to administer IV medications.
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Intravenous Medication Administration
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A quick response is needed during an emergency.
Clients have disorders (e.g., serious burns) that affect the
absorption or metabolism of drugs.
Blood levels of drugs need to be maintained at a
consistent therapeutic level such as when treating
infections caused by drug-resistant pathogens or
providing postoperative pain relief.
It is in the client's interest to avoid the discomfort of
repeated intramuscular injections.
A mechanism is needed to administer drug therapy over a
prolonged period, as with cancer.
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Continuous Administration
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A continuous infusion (instillation of a
parenteral drug over several hours), also called
a continuous drip, involves adding medication
to a large volume (500–1,000 mL) of IV
solution (Skill 35-1).
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Intermittent Administration
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Intermittent infusion is short-term (from
minutes up to 1 hour) parenteral administration
of medication. Intermittent infusions are
administered
in
three
ways:
bolus
administrations, secondary administrations,
and those in which a volume-control set is
used.
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Bolus Administration
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The term refers to a substance given all at one
time. A bolus administration (undiluted
medication given quickly into a vein)
sometimes is described as a drug given by IV
push.
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Bolus administrations are given in one of two
ways: through a port in an existing IV line or
through a medication lock (see Chap. 16).
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Using An IV Port
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A port (sealed opening) extends from the IV tubing
(Fig. 35-1).
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Because the entire dose is administered quickly,
bolus administration has the greatest potential for
causing life-threatening changes should a drug
reaction occur. If the client's condition changes for
any reason, the administration is ceased
immediately, and emergency measures are taken to
protect the client's safety.
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Figure 35-1 • An intravenous port .
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Using A Medication Lock
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A medication lock is also called a saline or
heparin lock or an intermittent infusion device.
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Nurses use the mnemonic “SAS” or “SASH” as
a guide to the steps involved in administering IV
medication into a lock. SAS stands for flush
with Saline—Administer drug—flush again with
Saline; SASH refers to flush with Saline—
Administer drug—flush again with Saline—
instill Heparin.
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To maintain patency, nurses usually flush
medication locks every 8 to 12 hours with
saline or heparin.
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Nurses change medication locks when
changing the IV site or at least every 72 hours.
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Secondary Infusions
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A secondary infusion is the administration of
a parenteral drug that has been diluted in a
small volume of IV solution, usually 50 to 100
mL, over 30 to 60 minutes. (Fig. 35-4).
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Figure 35-4 • Piggyback arrangement.
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Volume-Control Set
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A volume-control set is a chamber in IV
tubing that holds a portion of the solution from
a larger container (Fig. 35-5).
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Figure 35-5 • Volume-control set .
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Central Venous Catheters
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A central venous catheter (CVC; venous access
device that extends to the superior vena cava)
provides a means of administering parenteral
medication in a large volume of blood. A CVC is
used when:
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Clients require long-term IV fluid or medication
administration.
IV medications are irritating to peripheral veins.
It is difficult to insert or maintain a peripherally
inserted catheter.
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