the nurse should instruct a client who is taking dexamethasone and furosemide to report: This is a topic that many people are looking for. passionistsisters.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, passionistsisters.org would like to introduce to you IV Push (Direct IV) Medication Administration for Nurses. Following along are instructions in the video below:
Push medications i get asked a lot to do a video on how to do do iv. Push safely. So were going to tackle that right after this welcome my name is tammy and this is nurseminder and on this channel.
We do everything nursing. So if youre new here consider subscribing below so that you get the next video. When its released so iv push medications.
Requires several elements of nursing put into one task anytime. We get a medication order we need to be looking at our medication rights and so were not going to cover those today. Were really going to focus on the process that goes into iv push after the medication in medication rights are done next we want to determine if its in my scope of practice to understand that we need our parental manual.
All right so were working with our patient. Today. And we receive an order for ondansetron iv.
Push. The first place. We want to look to see if we can give it iv push is the parental manual routes of administration iv direct iv is the same as iv push and it says yes.
But theres this number one beside. It that means i need to do a little bit more reading to find out if i can give it so as i carry on in my parental manual. I see the required education equipment and monitoring number one says a health care professional must have a specialized clinical competency to administer direct iv.
A specialized clinical. Competency. Means.
That you have received additional education in the form of maybe. An online module or in class training. And have had some sort of assessment evaluation of it that may include a written exam.
A return demonstration. With an educator on a mannequin and or practical application with a real patient under the supervision of somebody else who can sign you off and once youve been deemed competent. Then you are allowed to do this independently the next thing.
We want to find is the usual dosing and here. We are at the adults section. In this so prevention of post operative.
Nausea and vomiting we can give im direct iv or infusion four milligrams as a single dose before induction of anesthesia or post operatively treatment of post. Op nausea and vomiting direct iv four milligrams as a single dose so this fits our order four milligrams iv push now times one dose what i want to go to next is the actual instructions for a direct iv for this medication. It says.
It can be administered undiluted at a two milligram per.
Ml concentration over two to five minutes. Now if ive never given ondansetron before i need to know where what its like where am i gonna find it what does it look like that information is also in here as well under product description. Its available as a 2 milligram per ml injection in a vial or ampule.
So i now know what im looking for and it doesnt have to be in a fridge. It can be at room temperature. So its probably just sitting on the counter somewhere so im gonna take a look for that all right so i have my ondansetron 2.
Milligram. Per ml l. And i found that its in ampule.
Now. This vial has got medication up here in the tip of the ampule and i dont want that so im going to simply give it a quick tip and you see the air has filled the ampule and the medication is now all here gathering. My supplies because this is an ampule and when i break off here.
Theres likely to be shards of glass that we cant see i need a blunt end needle a blunt fill needle. Yeah. Im gonna use a three ml syringe because im drawing up two mls.
My orders for 4 milligrams. Im gonna go ahead. And get my needle ready now to open up the ampule sometimes we end up cutting ourselves.
So if you work in a facility. That has the plastic sheath that goes on here awesome. If not i tend to use an alcohol swab to cover around here.
Im going to push with my thumb away from me. Such that it opens. Like that dscard your sharps and now i can grab my needle insert and i can withdraw in fact.
I can turn this right upside down. You see the fluid is not coming out and i can withdraw my 2 mls. Now you want to label your vial before you go into the patients room.
Ive got my ondansetron 2 milligrams. For mls. Theres no confusing.
I like to put it on the hubcap. So that when i remove it im not losing sight of my mls here so at the patients bedside in this scenario. We do have normal saline infusing.
So with my saline infusion running.
Im simply going to clean off my port closest to my patient for at least 15 seconds and i dont have to stop the saline here. Im simply going to let that run. Im now going to attach my ondansetron and i like to turn it so that i can see all of these lines.
I know i have to go at least two minutes. And i can go up to five so my tendency oops. Theres a little bit of air in there let me get rid of that first my tendency is to give a tenth so like ill take a push up to one line and ill take ten seconds for each subsequent line then the next 10 seconds.
Ill push up to this line make this easier for you to see 20 seconds. So im going to push in a tenth of an ml and then im gonna wait till 30 seconds im gonna push in the next ml or 1 10 of ml wait till 40 seconds and push in the next so you can see that its gonna take me so were already at 30 seconds. Now total duration and then pushing in there we go and you just continue on this until the two minutes or until.
The vial is empty actually which will take you just over two minutes now if my patient just has a saline lock were gonna clean this again for 15 seconds and for the interest of this video. Im going to fast forward this part. I have a saline flush here of which im going to then flush to make sure my iv is patent.
I only need 3 mils to do this part so im going to push in positive pressure. It shouldnt be resisting theres my 3 ml s. Im gonna discard this one and now that my line is flushed and patent i can go ahead and give my medication again i need to clean for 15 seconds for the interest.
We will we will fast forward that part attach my medication get my watch ready and i will do the same method. Im gonna turn it so i can see im gonna push at 15 seconds up one tenth of a ml and wait for the next push one tenth of a ml and wait until its 30 seconds. Im gonna push in the next tenth of a ml and pause and when we get to 40 seconds.
Im going to push in the next ten. So it actually feels like im doing something a little bit each step on the journey. But my patients getting their medication in a safe manner okay and well assume that this is all done now again we need to clean the hub every time we access we need to clean the hub and because its still full of medication i need to then instill three ccs of flush.
But going at the same rate. So im only going to just push in a little bit. Because thats full of medication currently.
I dont want to go too. Fast. Just push and pause.
Push and pause and once i feel ive got the medication through there i can finish off my last couple ccs of saline flush. Push and pause one more and i think thats going to cover it and now i can just infuse the last of that three ccs disconnect. And youre done so today.
Weve looked at several elements that are involved in giving iv push medications and weve talked about how to do it with an infusion and without an infusion. I hope this has been helpful. If you have any comments questions.
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