Chapter 7: Parenteral Medication Administration
7.6 Intravenous Medications by Direct IV (formerly IV push)
Critical Thinking Exercises: Questions, Answers, and Sources / References
- 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.
- 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
- 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)
- 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 |