Preparation and delivery of prescribed medications intravenously and evaluation of patient response. Used when rapid action is needed.
Objective:
– To administer prescribed medication to the patient intravenously for therapeutic and diagnostic purposes.
Equipment:
– Trough. – Serum support. – Compressor. – Sharps container.
Material:
– Prescribed medication. – Medical treatment sheet with the prescribed medication. – Non-sterile disposable gloves. – Sterile gloves. – Dressings. – Serum injector equipment. – Anti-allergic plaster.
– Sterile gauze. – Obturator. – 1 Intravenous needle 25 x 0.9-0.8. – 1 Syringe. – Compressor – Immobilization splint (infants and young children). – Cotton swab. – Antiseptic. – Medication identification label. – Nursing records.
Procedure:
– Perform hand washing. – Follow general rules in the administration of medication. – Prepare the medication: prepare the concentration of intravenous medication from an ampoule or vial. Maintain asepsis, disinfect the vial cap with antiseptic solution before loading. – Determine the patient’s knowledge of the medication and understanding of the method of administration. – Place the patient in a comfortable position according to the chosen injection site: supine decubitus, generally. – Put on sterile gloves. – Administration of intravenous bolus medication: depending on the duration time it is called bolus if it is less than one minute and slow intravenous if it is more than 2-5 minutes.
a) Direct injection:
1. Locate puncture site (preferably antecubital fossa) choose the largest caliber vein. 2. Place compressor 10-15 cm above the puncture site. 3. Apply antiseptic and let it dry. 4. Cross the skin with the needle connected to the syringe at an angle of 30º with the bevel upwards, introducing it inside the vein. 5. Check that the needle is in the vein by aspirating, if blood flows into the syringe it is correct. 6. Remove the compressor and inject the drug slowly. 7. Remove needle and syringe and apply pressure to the puncture site with sterile gauze for about 3 minutes. 8. Place dressing on the puncture site.
b) Through a cannulated line:
1. If 3-step tap is present:
– Remove plug. – Clean the entrance of the key with antiseptic. – Insert syringe and turn the key in the position to introduce medication. – Aspirate with the syringe verifying the patency of the line. – Administer medication slowly. – Clean the catheter with 2-3 ml of saline solution that will be prepared in another syringe. – Turn the key to its initial position, remove the syringe and replace the cap. Clean the inlet with antiseptic.
Administration of IV medication in intermittent perfusion:
1. This technique is applied for drugs that are diluted. 2. The duration of administration ranges from 15 minutes to several hours. 3. Puncture the medication container with a serum kit. 4. Administer the medication at the prescribed rate. 5. Withdraw system once the medication has been administered. – Administration of IV medication in continuous infusion: the infusion time is continuous, large volume serum is used as diluents and infusion pumps. – Assess the patient’s response to the medication and the appearance of possible adverse reactions. – Monitor the IV puncture site for infiltration or phlebitis. – Discard the needle and syringe in the container, according to waste segregation criteria. – Leave the patient in a comfortable position. – Collect the material. – Remove gloves. – Wash hands. – Record: medication administered, dose, route, date and time, incidents and patient response.
Observations:
– In case of obstruction, do not irrigate the IV to avoid embolism or infection. – Avoid multiple mixtures and if there are any, verify that there are no interactions. – Medication mixtures should be done with aseptic technique. – Monitor the puncture site daily for phlebitis, inflammation, infiltration, hematomas, etc. – In pediatric patients the volume of diluent should range between 5-50 c.c. depending on age and weight. – Do not administer together with medication: blood products, total parenteral nutrition, bicarbonate solutions and vasoactive drugs (dopamine, nitroglycerin, dobutamine, etc.).
– Signs and symptoms of anaphylactic reaction are: itching, skin rash, difficulty breathing, generalized edema, increased arterial blood pressure and heart rate, facial flushing, headache, or thoracic pressure, decreased consciousness, shock and cardiac arrest. – In newborns and infants, epicranial veins can be used up to one year of age. – In the application of medication by intravenous drip it is necessary to calculate the perfusion rate, taking into account that: 1ml=1cc=20 drops= 60 microdrops.
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