Administration & Calculation Of Drugs, Iv Fluids


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Administration & Calculation Of Drugs, Iv Fluids

  1. 1. Administration & Calculation of Drugs, IV fluids, Blood & Blood Components Mohammed Alhabsi Indanan Clinical Instructor King Abdul Aziz Specialist Hospital Taif, Kingdom of Saudi Arabia King Abdulaziz Specialist Hospital-Taif
  2. 2. Administration of Drugs <ul><li>Medication Ordering </li></ul><ul><li>Medication Transcription </li></ul><ul><li>Medication Administration </li></ul><ul><li>Medication Documentation </li></ul><ul><li>Unused Medication </li></ul><ul><li>Medication Safety </li></ul>
  3. 3. Administration of Drugs <ul><li>1. Medication Ordering </li></ul><ul><li>Written Orders </li></ul><ul><li>Verbal Orders </li></ul><ul><li>Telephone Orders </li></ul><ul><li>Unclear Order </li></ul>
  4. 4. Administration of Drugs <ul><li>2. Medication Transcription </li></ul><ul><li>3. Medication Administration: </li></ul><ul><li>RN </li></ul><ul><li>Standard medication time/with approved used of abbreviation </li></ul><ul><li>Do NOT use the Kardex to medicate </li></ul><ul><li>Report unexpected reaction, Medication Error </li></ul><ul><li>Error in preparation by the pharmacist </li></ul>
  5. 5. Administration of Drugs <ul><li>Observe the 7 rights </li></ul><ul><li>30 minutes before and or 30 minutes after the specified time ONLY. </li></ul><ul><li>Observe & document adverse reaction </li></ul><ul><li>Labeled open medication </li></ul><ul><li>Weight </li></ul><ul><li>2 RN’s Check the ff. medication; </li></ul><ul><ul><li>Narcotic & Controlled drugs, Anticoagulants, Chemotherapeutic drugs, Digoxin, Mg. Sulfate, K Chl., Heparin, Insulin, Aminophylline for pediatrics and all other High-Risk medications </li></ul></ul>
  6. 6. Administration IV Fluids <ul><li>Intravenous Therapy: </li></ul><ul><li>Introduction of fluids, blood, drugs directly into the vascular system for therapeutic & diagnostic purposes. </li></ul><ul><li>Intravenous Fluid : </li></ul><ul><li>Those fluids which are administered into the circulatory system through a vein. </li></ul>
  7. 7. Administration IV Fluids <ul><li>RN follow IV therapy protocol, including Infection Control guidelines </li></ul><ul><li>Only RN passed written test on med. Calculation & IV therapy </li></ul><ul><li>Completed 3 cannulations under supervision </li></ul><ul><li>Antibiotics in NICU: used SOLU-set </li></ul><ul><li>IV Digitalis & Narcotics: IV push given only in high risk area with cardiac monitoring </li></ul><ul><li>Strict aseptic technique </li></ul><ul><li>Verified order </li></ul><ul><li>Response to IV therapy </li></ul>
  8. 8. Drug Calculations <ul><li>Total volume to be infused X drop factor </li></ul><ul><li>Total hour X 60mins </li></ul><ul><li>500ml X 20 </li></ul><ul><li>8 hours X 60 </li></ul><ul><li>20.8 or 21 gtts/min </li></ul>
  9. 9. Drug Calculations <ul><li>D </li></ul><ul><li>H </li></ul><ul><li>25mg </li></ul><ul><li>100mg </li></ul><ul><li>0.5 ml </li></ul>X Q X 2ml
  10. 10. Blood & Blood Components <ul><li>BT- introduction of blood and/or its derivatives into the circulation </li></ul><ul><li>Ordering: </li></ul><ul><li>Product type </li></ul><ul><li>Amount </li></ul><ul><li>Flow rate & transfusion time </li></ul><ul><li>Date & time of administration </li></ul><ul><li>Signed consent </li></ul><ul><li>Request form must be fully completed </li></ul>
  11. 11. Blood & Blood Components <ul><li>Blood Products Availability: </li></ul><ul><li>Whole blood 450ml </li></ul><ul><li>Packed RBC 200ml </li></ul><ul><li>FFP 150ml </li></ul><ul><li>Platelets 50ml </li></ul><ul><li>Cryoprecipitate 50ml </li></ul>
  12. 12. Blood & Blood Components <ul><li>Packed RBC </li></ul><ul><li>Not be hang for more than 4 hours </li></ul><ul><li>Platelet Concentration </li></ul><ul><li>Administer quickly as possible but within not more than 30 minutes </li></ul><ul><li>Collected one at a time </li></ul><ul><li>150-280 micron filter Y type MUST be used. </li></ul><ul><li>FFP </li></ul><ul><li>Administered as quickly as possible but within less than 4 hours </li></ul>
  13. 13. Blood & Blood Components <ul><li>Cryoprecipitate </li></ul><ul><li>Administered as quickly as possible but within not more than 4 hours </li></ul><ul><li>All blood products directly transfuse & heparin Lock must be removed. </li></ul><ul><li>Recommended gauge: </li></ul><ul><ul><li>Adult : 18-20 </li></ul></ul><ul><ul><li>Paediatric: 22-24 </li></ul></ul><ul><ul><li>Neonate: 24-26 </li></ul></ul>
  14. 14. Blood & Blood Components <ul><li>New blood transfusion set for every unit of blood. </li></ul><ul><li>Infusion pump for paediatric patients, if not available Solu-set infusion with FILTER. </li></ul><ul><li>2 RN’s or RN together with a Physician will verify pt’s identity </li></ul><ul><li>Blood products shouldn’t stored in unit refrigerator </li></ul><ul><li>Check V/S </li></ul><ul><li>Used NSS for priming </li></ul><ul><li>If not started immediately, return to blood bank. </li></ul>
  15. 15. Blood & Blood Components <ul><li>Patient Identification before starting transfusion </li></ul><ul><li>Compare pts data in BT request </li></ul><ul><li>Confirm ABO & Rh compatibility by comparing/checking: </li></ul><ul><ul><li>The bag label </li></ul></ul><ul><ul><li>Expiration date </li></ul></ul><ul><ul><li>Satisfactory serology testing </li></ul></ul><ul><ul><li>Physician’s order sheet </li></ul></ul><ul><ul><li>BT request form </li></ul></ul><ul><li>The physician’s check the blood & request form & affix stamp & signature on the BT request before commencing transfusion. </li></ul>
  16. 16. Blood & Blood Components <ul><li>Initiation: </li></ul><ul><li>Inform & explain the procedure as well as desired outcome </li></ul><ul><li>Obtain & record baseline V/S </li></ul><ul><li>Hold if 38 degree </li></ul><ul><li>Inspect abnormal color, cloudiness, clots and present of air. </li></ul><ul><li>Check the expiration date written on the bag </li></ul><ul><li>Start infusion at 2ml/min </li></ul><ul><li>Stay with the pt for the 1 st 15-30mins. </li></ul><ul><li>Increased according to prescribed rate </li></ul><ul><li>Check V/S for the 1 st 15mins. Check Pulse 30mins., BP hourly, temp. 2 hourly </li></ul><ul><li>Report signs of reaction immediately. </li></ul>
  17. 17. Blood & Blood Components <ul><li>Transfusion Reaction Response: </li></ul><ul><li>Stop BT immediately </li></ul><ul><li>Change tubing and start Infusion NSS </li></ul><ul><li>Notify physician, Nsg. Supervisor </li></ul><ul><li>Check & Verify identification </li></ul><ul><li>Monitor & record V/S </li></ul><ul><li>Obtain blood sample from pt & distribute withdrawn sample to the ff. tubes to be sent to Hematology, Chemistry & Blood Bank </li></ul><ul><li>Collect urine specimen </li></ul><ul><li>Send blood bag with infusion set to Blood Bank with blood sample </li></ul><ul><li>Document </li></ul><ul><li>Initiate and write OVR </li></ul>
  18. 18. MAGSUKUL! Kanyu Katantan…