This document provides guidance on safely adding medications to intravenous lines and containers. It discusses assessing the intravenous site for complications before adding medications. Some key points covered include checking for drug compatibilities, using secondary bags or volume control sets to add compatible medications, flushing lines before and after to prevent incompatibilities, and administering intermittent or push injections through saline locks or into continuous lines while monitoring for reactions. The document emphasizes implementing the rights of medication administration and checking guidelines for each specific drug.

1. Adding medications to
an intravenous container
Presented By
Mrs.Usha Rani Kandula, MSc(N),
Assistant professor in Adult health nursing, Department of Clinical
nursing, Arsi University, College of health sciences, Asella, Ethiopia,
Institutional email: usharani2020@arsiun.edu.et.

2. Adding Drugs to an
Intravenous Fluid Container
When administering IV medications,
-The nurse should assess the patency of the infusion system
-The condition of the injection site for signs of complications such as
-Infiltration
(swelling and discomfort at the IV site)
-phlebitis
(inflammation of a vein).

3. -Some IV medications or solutions with high or low pH or high
osmolarity are irritating to veins and can cause phlebitis.
-Before administering any IV medication, the nurse should note the
client’s allergies, drug or solution incompatibilities, the client’s general
condition to establish a baseline for administering medication.

4. -Examples of drugs that can be added to an IV fluid container that is
infusing are potassium chloride, an electrolyte, a vitamin.
-The nurse should check for drug compatibilities of drug additives
before injecting a medication into an infusion bag.

5. -Drug incompatibilities cause an undesired chemical or physical
reaction between a drug and a solution, between two drugs, or
between a drug and the container or tubing.
-Insulin should not be added to an infusion bag because the insulin
adheres to the inside of the solution bag.

6. ADDING DRUGS TO A VOLUME-
CONTROL ADMINISTRATION SET

7. Adding Drugs to a Volume-Control Administration Set
-A volume-control set is used to administer small volumes of IV solution.
-These devices have various names as determined by the manufacturer,
such as Soluset, Metriset, VoluTrol, or Buretrol.
-To administer a drug by this method, the nurse should:
• Withdraw the prescribed amount of medication into a syringe that is to
be injected into the volume-control set.

8. -Cleanse the injection port of a partially filled volume control set with
an alcohol swab.
• Inject the prepared medication into the port of the volume-control set .
• Gently mix the solution in the volume-control chamber.
-After injecting the medication into the volume-control chamber, the
nurse should check the infusion rate and adjust as necessary to the
prescribed rate of infusion.

9. ADMINISTERING MEDICATIONS
BY INTERMITTENT INFUSION

10. Administering Medications by Intermittent Infusion
-A common method of administering IV medications is by using a
secondary, or partial-fill additive bag, often referred to as an IV
piggyback (IVPB).
-A secondary line is a complete IV set (fluid container and tubing with
either a microdrip or a macrodrip system) connected to a Y–port of a
primary line.

11. -The primary line maintains venous access.
-The IVPB is used for medication administration.
- When the IVPB medication is incompatible with the primary IV
solution, the nurse must flush the primary IV tubing with normal saline
before and after administering the medication.

12. INTERMITTENT INFUSION DEVICES

13. Intermittent infusion devices
-When the client requires only the administration of IV medications
without the infusion of solutions, an intermittent infusion device is
inserted into a peripheral needle or catheter in the client’s vein.
-This device is commonly referred to as a heparin or saline lock
depending on the agency’s policy regarding the device’s maintenance.

14. -A lock provides continuous access to venous circulation, eliminating
the need for a continuous IV, and it increases the client’s mobility.
-The device can be used to infuse intermittent IVPB or IV push
medications, or it can be converted to a primary IV.
-A major consideration for inserting a heparin lock device is that it
provides venous access in case of an emergency.
-Lock devices are routinely used with cardiac clients.

15. -Locks are generally flushed every 8 hours to maintain patency
(patency refers to being freely opened).
-Some agencies require a diluted dose of heparin (100 units/ml) to be
injected into the lock; other agencies use normal saline to keep the
device patent.
-When heparin is used, the devise must be flushed with normal saline
solution before and after administration of a medication.

16. ADMINISTERING IV PUSH
MEDICATIONS

17. Administering IV Push Medications
-The method of medication administration by IV bolus or IV push
injection is determined by the type of IV system.
-For example, an IV push medication can be injected into a saline or
heparin lock or into a continuous infusion line.
-When giving an IV push medication into a continuous infusion line, the
nurse
must stop the fluids in the primary line; the nurse usually pinches the
IV tubing closed to inject the drug .
-This technique is safe and prevents the nurse from having to
recalculate the drip rate of the primary infusion line.

18. -IV push medications can also be given into a central line or directly
into the vessel by venipuncture.
-The rights of medication administration are implemented when
administering an IV bolus.
-The nurse must know the specific time interval to inject the medication
and
the specific reactions of the infused drug.
-The client must be monitored closely during and after injection for
drug reactions.

23. THANKING YOU