Transcript week 6 IV push meds pptx

What is an IV push medication?
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Davis’s Drug Guide: “Direct IV”
Gahart: “IV injection”
Also called IV “bolus”, or just bolus.
Bolus = “concentrated medication or
solution given rapidly over a short period of
time; …direct I.V. injection or I.V. drip” (Phillips,
IV Therapeutics, p. 625)
• Institutional as well as pharmacological
guidelines must be followed.
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6 reasons for medications to be
administered IV push.
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Rapid onset
Improved serum drug concentrations
Able to administer when NPO
IM painful
Some drugs can only be given IV
“Loading dose”
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Describe 4 complications r/t via IVP meds
1. Incompatibilities
– Physical:
– Chemical:
– Therapeutic:
2. Speed shock:
3. Vascular irritation
4. Rapid onset of action
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IV Policy from Student Handbook
• In semester 2 and 3, students will give IV
push medications only under the direct
supervision of their instructor.
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Cautions
• Don’t mix 2 drugs in syringe, even if
compatible
• Wait until later to use?
• Label all syringes
• Always give IV push meds under the direct
supervision of your instructor.
• Don’t throw the ampule/vial away
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Prior to giving a med IV Push:
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5 rights
Generic and brand name
Classification
Why getting drug – expected effects
Is this an appropriate dose?
Patient teaching
Onset & duration of action
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Additional steps prior to giving an IVP med
• Compatibility
• Rate of administration
• Need to be diluted?
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Example from Gahart:
Metoclopramide 10 mg IV q. 6 hours
• Dilution:
– May be given undiluted if dose does not exceed 10
mg. For doses >10 mg dilute in at least 50 mL of
D5W, NS, …, and give as an infusion.
• Rate of Administration:
– Too rapid IV injection will cause intense anxiety,
restlessness, and then drowsiness.
– IV injection: 10 mg or fraction thereof over 2
minutes.
– Infusion: Administer over a minimum of 15 minutes.
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Compatibility example: metoclopramide
“Consider any drug NOT listed as compatible to
be INCOMPATIBLE until consulting a
pharmacist”
Manufacturer lists as incompatible…
Sources suggest the following compatibilities:
– Additive: Manufacturer lists…
– Y-site: All drugs listed by the manufacturer as
compatible under Additive. Other sources add
[A long list, alphabetical]
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IV push med through a peripheral lock
SAS:
• Saline
• Administer med
• Saline
What type of adaptor do you have? Positive
pressure or negative pressure?
Reminder: The technique differs!!
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IV push med through a Central line lok
Remember w/CVAD: 10 mL syringe or
larger
SAS
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Saline
Administer med
Saline
Positive pressure access device:
– Remove syringe, then clamp tubing
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Skills Competency
1. Saline lock flush – either peripheral or central
(all scenarios will include).
2. IVPB (bag w/secondary tubing)
– Gentamicin Sulfate
– Ceftriaxone Sodium (Rocephin)
– Levofloxacin (Levaquin)
3. Central line dressing change
4. IV push
– Pepcid
– Reglan
– Lasix (furosemide)
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