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Golden Rules in Drug Administration Uses and Indication of IV Medications Calculations of Drug Dosage & IV Rates Nelia B. ...
The 5 + 6 Rights <ul><li>Right Drug </li></ul><ul><li>Right Patient </li></ul><ul><li>Right Dose </li></ul><ul><li>Right R...
<ul><li>Right Approach </li></ul><ul><li>Right Assessment </li></ul><ul><li>Right Education </li></ul><ul><li>Right to Ref...
IV’s OVERVIEW <ul><li>IV solutions are instilled through a vein.  </li></ul><ul><li>Includes water, chemicals, blood, bloo...
<ul><li>IV Drug Administration involves injecting or infusing the drug directly into the blood circulation, allowing for r...
IV DRUGS ARE ADMINISTERED FOR : <ul><li>Restoring fluid balance secondary to trauma, illness, or dehydration. </li></ul><u...
ADVANTAGES/DISADVANTAGES <ul><li>ADVANTAGES </li></ul><ul><li>Drug or solutions enter bloodstream instantly and circulate ...
INFUSION TECHNIQUES <ul><li>CONTINUOUS; </li></ul><ul><li>Administration of a drug over a period of several hours. </li></...
INFUSION TECHNIQUES (CONT) <ul><li>SECONDARY INFUSION: </li></ul><ul><li>Administration of a drug that has been diluted in...
IV COMPLICATIONS <ul><li>CIRCULATORY OVERLOAD </li></ul><ul><li>INFILTRATION  </li></ul><ul><li>THROMBUS  </li></ul><ul><l...
COMPLICATIONS <ul><li>CIRCULATORY OVERLOAD: </li></ul><ul><li>Symptoms: Increased BP, SOB, Anxiety. </li></ul><ul><li>Caus...
COMPLICATIONS (CONT) <ul><li>THROMBUS: </li></ul><ul><li>Symptoms: Pain, swelling. </li></ul><ul><li>Cause: Cannula point ...
COMPLICATIONS (CONT) <ul><li>INFECTION: </li></ul><ul><li>Symptoms: Redness, puffiness.  Purulent drainage.  </li></ul><ul...
COMPLICATIONS (CONT) <ul><li>AIR EMBOLUS: </li></ul><ul><li>Symptoms: Drop in BP, Tachycardia, Decreased  LOC, Cyanosis. <...
GENERAL INFORMATION <ul><li>The longer the duration of infusion, the more likely complication are to occur. </li></ul><ul>...
<ul><li>TOTAL VOLUME IN MILLILITERS </li></ul><ul><li>TOTAL HOURS </li></ul><ul><li>EXAMPLE:  1000ML GIVEN OVER 8HRS </li>...
CALCULATIONS DROP RATE: REGULAR : 15GTTS/ML MACRO: 10GTTS/ML  (BLOOD) MICRO: 60GTTS/ML  (INFANTS/PEDS) EXAMPLE: 1000ML OVE...
IV Drug Calculations <ul><li>Dosage_   x  Quantity </li></ul><ul><li>Stock </li></ul>
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  1. 1. Golden Rules in Drug Administration Uses and Indication of IV Medications Calculations of Drug Dosage & IV Rates Nelia B. Perez RN, MSN IV Therapist Northeastern College Santiago City, Philippines 3311
  2. 2. The 5 + 6 Rights <ul><li>Right Drug </li></ul><ul><li>Right Patient </li></ul><ul><li>Right Dose </li></ul><ul><li>Right Route </li></ul><ul><li>Right Frequency </li></ul>
  3. 3. <ul><li>Right Approach </li></ul><ul><li>Right Assessment </li></ul><ul><li>Right Education </li></ul><ul><li>Right to Refuse </li></ul><ul><li>Right Documentation </li></ul><ul><li>Right Evaluation </li></ul>
  4. 4. IV’s OVERVIEW <ul><li>IV solutions are instilled through a vein. </li></ul><ul><li>Includes water, chemicals, blood, blood products, and meds. </li></ul>
  5. 5. <ul><li>IV Drug Administration involves injecting or infusing the drug directly into the blood circulation, allowing for rapid distribution throughout the body. </li></ul><ul><li>Provides the greatest bioavailability </li></ul>
  6. 6. IV DRUGS ARE ADMINISTERED FOR : <ul><li>Restoring fluid balance secondary to trauma, illness, or dehydration. </li></ul><ul><li>Maintain fluid balance when pt is NPO. </li></ul><ul><li>Administer medication/electrolytes/vitamins. </li></ul><ul><li>Administer anesthesia. </li></ul><ul><li>Administer blood/blood products. </li></ul><ul><li>Long-term pain management. (avoids multiple injections) </li></ul><ul><li>Trauma. </li></ul><ul><li>Maintain blood levels of drugs. </li></ul><ul><li>Establish access to vascular system for Dialysis, etc. </li></ul>
  7. 7. ADVANTAGES/DISADVANTAGES <ul><li>ADVANTAGES </li></ul><ul><li>Drug or solutions enter bloodstream instantly and circulate into the tissue. This can be considered a disadvantage also. </li></ul><ul><li>DISADVANTAGE </li></ul><ul><li>Fluids cannot be retrieved in the event of an error. </li></ul><ul><li>Extreme caution must be used. </li></ul><ul><li>Needle or catheter must be used to provide entry. </li></ul><ul><li>Materials must be sterile to prevent infection. </li></ul>
  8. 8. INFUSION TECHNIQUES <ul><li>CONTINUOUS; </li></ul><ul><li>Administration of a drug over a period of several hours. </li></ul><ul><li>INTERMITTENT: </li></ul><ul><li>Administration of medication in a relatively short span. </li></ul><ul><li>BOLUS: </li></ul><ul><li>Medication given all at one time. Through an existing port or lock. </li></ul>
  9. 9. INFUSION TECHNIQUES (CONT) <ul><li>SECONDARY INFUSION: </li></ul><ul><li>Administration of a drug that has been diluted in a small volume of IV solution, usually over 30-60minutes. (Piggyback) Hang higher than Primary. </li></ul><ul><li>VOLUME CONTROL SET: </li></ul><ul><li>Chamber in IV tubing that holds a portion of the solution from a larger container. Avoids overloading Circulatory System. (Volutrol, Buretrol, Soluset.) </li></ul>
  10. 10. IV COMPLICATIONS <ul><li>CIRCULATORY OVERLOAD </li></ul><ul><li>INFILTRATION </li></ul><ul><li>THROMBUS </li></ul><ul><li>THROMBOPHLEBITIS </li></ul><ul><li>INFECTION </li></ul><ul><li>PULMONARY EMBOLUS </li></ul><ul><li>AIR EMBOLISM </li></ul>
  11. 11. COMPLICATIONS <ul><li>CIRCULATORY OVERLOAD: </li></ul><ul><li>Symptoms: Increased BP, SOB, Anxiety. </li></ul><ul><li>Cause: Rapid infusion, reduced kidney function, impaired heart </li></ul><ul><li>contractions. </li></ul><ul><li>Action: First action of nurse is to assess for Respiratory </li></ul><ul><li>Distress (VS), then Decrease Flow-Rate, Fowler’s </li></ul><ul><li>position, call Physician. </li></ul><ul><li>INFILTRATION: </li></ul><ul><li>Symptoms: Swelling at site, burning, color-pallor, coldness, slow </li></ul><ul><li>or no rate. </li></ul><ul><li>Cause: Solution escaping into subcutaneous tissue. </li></ul><ul><li>Action: Restart IV, elevate, warm compress X 20 minutes. </li></ul>
  12. 12. COMPLICATIONS (CONT) <ul><li>THROMBUS: </li></ul><ul><li>Symptoms: Pain, swelling. </li></ul><ul><li>Cause: Cannula point traumatizes wall of vein. Thrombi form on the vein and tip of cannula. Traps bacteria. </li></ul><ul><li>Action: D/C site. Call physician. </li></ul><ul><li>THROMBOPHLEBITIS: </li></ul><ul><li>Symptoms: Pain along length of vein. Vein becomes increasingly </li></ul><ul><li>painful and hard. </li></ul><ul><li>Cause: Thrombus with inflammation, chemicals or irritation. </li></ul><ul><li>Action: Watch for Septicemia and Acute bacterial endocarditis. D/C IV, notify Physician. </li></ul>
  13. 13. COMPLICATIONS (CONT) <ul><li>INFECTION: </li></ul><ul><li>Symptoms: Redness, puffiness. Purulent drainage. </li></ul><ul><li>Temperature and chills. </li></ul><ul><li>Cause: Spread of bacteria. </li></ul><ul><li>Action: D/C site. Notify physician. Culture if </li></ul><ul><li>necessary. </li></ul><ul><li>PULMONARY EMBOLUS: </li></ul><ul><li>Symptoms: SOB, Anxiety, Sudden Chest Pain, Rapid </li></ul><ul><li>heart rate with a drop in BP. </li></ul><ul><li>Cause: Movement of previously stationary blood clot. </li></ul><ul><li>Action: Stay with patient and call for assistance. </li></ul>
  14. 14. COMPLICATIONS (CONT) <ul><li>AIR EMBOLUS: </li></ul><ul><li>Symptoms: Drop in BP, Tachycardia, Decreased LOC, Cyanosis. </li></ul><ul><li>Cause: Air enters vein, disconnected tubing, running solutions simultaneously, lethal amount unknown. Associated with Central Lines. </li></ul><ul><li>Action: Trendelenberg position on L side. (air rises to R atrium, preventing it from entering the Pulmonary Artery. </li></ul><ul><ul><ul><ul><ul><li>CALL FOR ASSISTANCE </li></ul></ul></ul></ul></ul>
  15. 15. GENERAL INFORMATION <ul><li>The longer the duration of infusion, the more likely complication are to occur. </li></ul><ul><li>Solutions/meds are irritating to the vein. </li></ul><ul><li>Cannula’s can irritate and pierce venous walls causing complications. </li></ul><ul><li>Small veins are more likely to be irritated. </li></ul><ul><li>Cannula can occlude vein and prevent blood flow. </li></ul><ul><li>Veins in lower extremities are a factor when there is pooling or stagnant blood. </li></ul><ul><li>Poor technique can cause inflammation and infection. </li></ul><ul><li>Phlebitis with sepsis is associated with technique. (like disconnecting a gown) </li></ul><ul><li>Infection is a risk. Skin must be thoroughly and properly cleansed to maintain asepsis. Such as thorough handwashing. </li></ul>
  16. 16. <ul><li>TOTAL VOLUME IN MILLILITERS </li></ul><ul><li>TOTAL HOURS </li></ul><ul><li>EXAMPLE: 1000ML GIVEN OVER 8HRS </li></ul><ul><li>1000ML = 125ML/HR </li></ul><ul><li>8HOURS </li></ul>IV CALCULATION
  17. 17. CALCULATIONS DROP RATE: REGULAR : 15GTTS/ML MACRO: 10GTTS/ML (BLOOD) MICRO: 60GTTS/ML (INFANTS/PEDS) EXAMPLE: 1000ML OVER 12 HRS (ADULT) VOLUME X SIZE OF DROP TIME (IN MINUTES) 1000x15 = 21GTTS/MIN 60MINx12HRS
  18. 18. IV Drug Calculations <ul><li>Dosage_ x Quantity </li></ul><ul><li>Stock </li></ul>

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