Chapter 7: Parenteral Medication Administration

7.6 Intravenous Medications by Direct IV (formerly IV push)

Critical Thinking Exercises: Questions, Answers, and Sources / References

  1. Find a resource that will advise you about onset, peak, and duration of morphine IV.

Answer: this will vary depending on where the student is working / learning. Generally institutions will provide nurses with IV medication manuals which contain a condensed, clear version of each IV medication drug monograph.

Example: F.A. Davis. (2019). Davis Drug Guide – Morphine. https://www.drugguide.com/ddo/view/Davis-Drug-Guide/51518/all/morphine

 

2. What information should be on the label of an IV medication syringe after it is prepared?

Answer: 2 patient identifiers, medication name, medication dose, date / time of preparation, who prepared / administered the medication

Source: Perry, A., Potter, P., & Ostendorf, W. (2018). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.

Sample Quiz Questions
  1. Which of the following routes should have the quickest onset of action when administering medications?
  • a. IV
  • b. ID
  • c. SC
  • d. IM

Answer: IV

Source: Perry, A., Potter, P., & Ostendorf, W. (2017). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.

 

2. A patient is ordered furosemide 20 mg IV daily. The ampule provides 40mg/4ml. How many ml are needed for the correct dose? Answer:

want   x drug form  = 20 mg x 4ml = 80 ml = 2ml

have                             40 mg               40

  1. The drug monograph suggests the medication can be given minibag or IV direct. Provide rationale for your decision about how you will deliver the medication.

Answer: either route is safe. Considering that the rationale for furosemide is to cause diuresis,  IV direct might be the preferable option considering it is a smaller volume. Always consider patient factors in the decision to administer medications direct or via a mini bag (ie. IV site, preexisting health challenges)

  1. You are giving morphine 5 mg IV direct. The parenteral practices manual advises to administer maximum 2mg / minute. How many minutes should it take to administer the dose? Answer: 

  5 mg        x    minute   =   2.5 minutes

                        2mg

 

5. You are administering a medication IV direct. As you start injecting the medication, you notice white crystals developing in the IV tubing. What is your next action?

Action Answer
a. Consider that this is an incompatibility issue This is true but action is necessary
b. Stop and flush the line with saline Incorrect. Flushing the line with saline will cause some of the white crystals to go into the patients vascular circulation and potentially cause harm
c. Stop and get a new IV administration set Correct. It is important that the crystals not enter the patient’s vascular system
d. Notify the prescriber Incorrect. While this is a good strategy the first thing you need to do is protect the patient