{"id":237,"date":"2019-09-16T09:43:45","date_gmt":"2019-09-16T13:43:45","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/?post_type=chapter&#038;p=237"},"modified":"2020-03-23T14:32:05","modified_gmt":"2020-03-23T18:32:05","slug":"7-6","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/chapter\/7-6\/","title":{"raw":"7.6 Intravenous Medications by Direct IV (formerly IV push)","rendered":"7.6 Intravenous Medications by Direct IV (formerly IV push)"},"content":{"raw":"<h2 style=\"text-align: center\"><strong>Critical Thinking Exercises: Questions, Answers, and Sources \/ References<\/strong><\/h2>\r\n<ol>\r\n \t<li><strong>Find a resource that will advise you about onset, peak, and duration of morphine IV.<\/strong><\/li>\r\n<\/ol>\r\n<em>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.<\/em>\r\n\r\n<em>Example: F.A. Davis. (2019). <\/em><em>Davis<\/em><em> Drug Guide \u2013 Morphine. <\/em><a href=\"https:\/\/www.drugguide.com\/ddo\/view\/Davis-Drug-Guide\/51518\/all\/morphine\">https:\/\/www.drugguide.com\/ddo\/view\/Davis-Drug-Guide\/51518\/all\/morphine<\/a>\r\n\r\n&nbsp;\r\n\r\n2. <strong>What information should be on the label of an IV medication syringe after it is prepared?<\/strong>\r\n\r\n<em>Answer: 2 patient identifiers, medication name, medication dose, date \/ time of preparation, who prepared \/ administered the medication<\/em>\r\n\r\nSource:\u00a0Perry, A., Potter, P., &amp; Ostendorf, W. (2018). <em>Clinical skills and nursing techniques<\/em> (9th ed.). St. Louis, MO: Elsevier-Mosby.\r\n<div class=\"textbox shaded\" style=\"text-align: center\"><strong>Sample Quiz Questions<\/strong><\/div>\r\n<ol>\r\n \t<li><strong>Which of the following routes should have the quickest onset of action when administering medications?<\/strong><\/li>\r\n<\/ol>\r\n<ul>\r\n \t<li>a. IV<\/li>\r\n \t<li>b. ID<\/li>\r\n \t<li>c. SC<\/li>\r\n \t<li>d. IM<\/li>\r\n<\/ul>\r\n<em>Answer: IV<\/em>\r\n\r\nSource: Perry, A., Potter, P., &amp; Ostendorf, W. (2017). <em>Clinical skills and nursing techniques<\/em> (9th ed.). St. Louis, MO: Elsevier-Mosby.\r\n\r\n&nbsp;\r\n\r\n<strong>2. A patient is ordered furosemide 20 mg IV daily. The ampule provides 40mg\/4ml. How many ml are needed for the correct dose?<\/strong> <em>Answer: <\/em>\r\n\r\n<em><span style=\"text-decoration: underline\">want<\/span>\u00a0 \u00a0x drug form\u00a0 = <span style=\"text-decoration: underline\">20 mg<\/span> x 4ml = <span style=\"text-decoration: underline\">80 ml<\/span> = 2ml<\/em>\r\n\r\nhave\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a040 mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a040\r\n<ol start=\"3\">\r\n \t<li>T<strong>he drug monograph suggests the medication can be given minibag or IV direct. Provide rationale for your decision about how you will deliver the medication.<\/strong><\/li>\r\n<\/ol>\r\nAnswer: either route is safe. Considering that the rationale for furosemide is to cause diuresis,\u00a0 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)\r\n<ol start=\"4\">\r\n \t<li><strong>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?<\/strong> <em>Answer:\u00a0<\/em><\/li>\r\n<\/ol>\r\n<em> \u00a0 5 mg\u00a0 \u00a0 \u00a0 \u00a0 x\u00a0 \u00a0\u00a0<span style=\"text-decoration: underline\">minute<\/span>\u00a0 \u00a0=\u00a0 \u00a02.5 minutes<\/em>\r\n\r\n<em>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 2mg<\/em>\r\n\r\n&nbsp;\r\n\r\n5. <strong>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?<\/strong>\r\n<table style=\"border-collapse: collapse;width: 100.09%;height: 74px\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 14px\">\r\n<td style=\"width: 3.96985%;height: 14px\"><\/td>\r\n<td style=\"width: 34.575%;height: 14px\">Action<\/td>\r\n<td style=\"width: 89.3247%\"><em>Answer<\/em><\/td>\r\n<\/tr>\r\n<tr style=\"height: 14px\">\r\n<td style=\"width: 3.96985%;height: 14px\">a.<\/td>\r\n<td style=\"width: 34.575%;height: 15px\">Consider that this is an incompatibility issue<\/td>\r\n<td style=\"width: 89.3247%\"><em>This is true but action is necessary<\/em><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td style=\"width: 3.96985%;height: 15px\">b.<\/td>\r\n<td style=\"width: 34.575%;height: 15px\">Stop and flush the line with saline<\/td>\r\n<td style=\"width: 89.3247%\"><em>Incorrect. Flushing the line with saline will cause some of the white crystals to go into the patients vascular circulation and potentially cause harm<\/em><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td style=\"width: 3.96985%;height: 15px\">c.<\/td>\r\n<td style=\"width: 34.575%;height: 15px\">Stop and get a new IV administration set<\/td>\r\n<td style=\"width: 89.3247%\"><em>Correct. It is important that the crystals not enter the patient\u2019s vascular system<\/em><\/td>\r\n<\/tr>\r\n<tr style=\"height: 15px\">\r\n<td style=\"width: 3.96985%;height: 15px\">d.<\/td>\r\n<td style=\"width: 34.575%;height: 15px\">Notify the prescriber<\/td>\r\n<td style=\"width: 89.3247%\"><em>Incorrect. While this is a good strategy the first thing you need to do is protect the patient<\/em><\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n&nbsp;","rendered":"<h2 style=\"text-align: center\"><strong>Critical Thinking Exercises: Questions, Answers, and Sources \/ References<\/strong><\/h2>\n<ol>\n<li><strong>Find a resource that will advise you about onset, peak, and duration of morphine IV.<\/strong><\/li>\n<\/ol>\n<p><em>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.<\/em><\/p>\n<p><em>Example: F.A. Davis. (2019). <\/em><em>Davis<\/em><em> Drug Guide \u2013 Morphine. <\/em><a href=\"https:\/\/www.drugguide.com\/ddo\/view\/Davis-Drug-Guide\/51518\/all\/morphine\">https:\/\/www.drugguide.com\/ddo\/view\/Davis-Drug-Guide\/51518\/all\/morphine<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>2. <strong>What information should be on the label of an IV medication syringe after it is prepared?<\/strong><\/p>\n<p><em>Answer: 2 patient identifiers, medication name, medication dose, date \/ time of preparation, who prepared \/ administered the medication<\/em><\/p>\n<p>Source:\u00a0Perry, A., Potter, P., &amp; Ostendorf, W. (2018). <em>Clinical skills and nursing techniques<\/em> (9th ed.). St. Louis, MO: Elsevier-Mosby.<\/p>\n<div class=\"textbox shaded\" style=\"text-align: center\"><strong>Sample Quiz Questions<\/strong><\/div>\n<ol>\n<li><strong>Which of the following routes should have the quickest onset of action when administering medications?<\/strong><\/li>\n<\/ol>\n<ul>\n<li>a. IV<\/li>\n<li>b. ID<\/li>\n<li>c. SC<\/li>\n<li>d. IM<\/li>\n<\/ul>\n<p><em>Answer: IV<\/em><\/p>\n<p>Source: Perry, A., Potter, P., &amp; Ostendorf, W. (2017). <em>Clinical skills and nursing techniques<\/em> (9th ed.). St. Louis, MO: Elsevier-Mosby.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>2. A patient is ordered furosemide 20 mg IV daily. The ampule provides 40mg\/4ml. How many ml are needed for the correct dose?<\/strong> <em>Answer: <\/em><\/p>\n<p><em><span style=\"text-decoration: underline\">want<\/span>\u00a0 \u00a0x drug form\u00a0 = <span style=\"text-decoration: underline\">20 mg<\/span> x 4ml = <span style=\"text-decoration: underline\">80 ml<\/span> = 2ml<\/em><\/p>\n<p>have\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a040 mg\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a040<\/p>\n<ol start=\"3\">\n<li>T<strong>he drug monograph suggests the medication can be given minibag or IV direct. Provide rationale for your decision about how you will deliver the medication.<\/strong><\/li>\n<\/ol>\n<p>Answer: either route is safe. Considering that the rationale for furosemide is to cause diuresis,\u00a0 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)<\/p>\n<ol start=\"4\">\n<li><strong>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?<\/strong> <em>Answer:\u00a0<\/em><\/li>\n<\/ol>\n<p><em> \u00a0 5 mg\u00a0 \u00a0 \u00a0 \u00a0 x\u00a0 \u00a0\u00a0<span style=\"text-decoration: underline\">minute<\/span>\u00a0 \u00a0=\u00a0 \u00a02.5 minutes<\/em><\/p>\n<p><em>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 2mg<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>5. <strong>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?<\/strong><\/p>\n<table style=\"border-collapse: collapse;width: 100.09%;height: 74px\">\n<tbody>\n<tr style=\"height: 14px\">\n<td style=\"width: 3.96985%;height: 14px\"><\/td>\n<td style=\"width: 34.575%;height: 14px\">Action<\/td>\n<td style=\"width: 89.3247%\"><em>Answer<\/em><\/td>\n<\/tr>\n<tr style=\"height: 14px\">\n<td style=\"width: 3.96985%;height: 14px\">a.<\/td>\n<td style=\"width: 34.575%;height: 15px\">Consider that this is an incompatibility issue<\/td>\n<td style=\"width: 89.3247%\"><em>This is true but action is necessary<\/em><\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td style=\"width: 3.96985%;height: 15px\">b.<\/td>\n<td style=\"width: 34.575%;height: 15px\">Stop and flush the line with saline<\/td>\n<td style=\"width: 89.3247%\"><em>Incorrect. Flushing the line with saline will cause some of the white crystals to go into the patients vascular circulation and potentially cause harm<\/em><\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td style=\"width: 3.96985%;height: 15px\">c.<\/td>\n<td style=\"width: 34.575%;height: 15px\">Stop and get a new IV administration set<\/td>\n<td style=\"width: 89.3247%\"><em>Correct. It is important that the crystals not enter the patient\u2019s vascular system<\/em><\/td>\n<\/tr>\n<tr style=\"height: 15px\">\n<td style=\"width: 3.96985%;height: 15px\">d.<\/td>\n<td style=\"width: 34.575%;height: 15px\">Notify the prescriber<\/td>\n<td style=\"width: 89.3247%\"><em>Incorrect. While this is a good strategy the first thing you need to do is protect the patient<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n","protected":false},"author":397,"menu_order":4,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-237","chapter","type-chapter","status-publish","hentry"],"part":227,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/237","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/users\/397"}],"version-history":[{"count":7,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/237\/revisions"}],"predecessor-version":[{"id":733,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/237\/revisions\/733"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/parts\/227"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapters\/237\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/media?parent=237"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/pressbooks\/v2\/chapter-type?post=237"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/contributor?post=237"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/facultyancillaryresourceforclinicalproceduresforsaferpatient\/wp-json\/wp\/v2\/license?post=237"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}