BLOCK 10 – Module 1 – Dosage Calculations, IV Medications, Blood Transfusions, and Parenteral Nutrition

BLOCK 10 – Module 1 – Dosage Calculations, IV Medications, Blood Transfusions, and Parenteral Nutrition
Therapy
Dosage Calculations (PowerPoint)
IV Solutions
Provides rapid therapeutic effect
Can lead to immediate serious reactions
Isotonic: parenteral solution within osmolarity of 270-300 mOsm/L.
When infused, fluid d/n move into or out of body cells. Pt is at risk for fluid overload.
Hypertonic: fluids greater than 300 (parenteral nutrition is this)
Used to correct fluid and electrolyte and acid-base imbalances by moving water out of the
bodies cells into the blood stream.
Hypotonic: fluids less than 270
Fluid moves into the cells.
IV and IV Push Medications
IV Push
IV push medications are injected directly into the IV port using a syringe.
Flush the line before and after giving med with 10 ml of normal saline or per facility
protocol
Adverse Reactions
Severe adverse reactions may occur quickly
Hypersensitivity to IV medications can occur immediately
The most severe reaction is anaphylaxis  Dramatic and acute, marked by sudden onset of rapid articaria and respiratory distress The most common anaphylaxis causing medication is Penicillin at parental
administration
Nursing Responsibilities
Medication indications and proper dosage
Contraindications and precautions
Appropriate dilution, rate of infusion, pH & osmolarity, and compatibility with other IV
meds
Never assume that IV administration is the same as giving the medication by other routes
Preparing Medications for IV administration, follow these safety rules:
Check expiration date
Maintain sterile technique
Inspect the medication, diluent, and solution for particles or cloudiness
Documentation
Nursing Responsibilities
oSix Rights
Right medication
Right dose
Right time
Right client
Right route
Right documentation; document immediately after giving the medication, if not given
indicate why on the MAR and nursing notes
oThree Medication Checks
Check #1: compare the med label to the MAR as you remove the medication from the
storage area
Check #2: compare the med label to the MAR as you prepare each medicationThis study source was downloaded by 100000830212155 from CourseHero.com on 08-13-2021 06:16:36 GMT -05:00
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Check #3: compare the med label to the MAR at the client’s bedside before you give each
medication
Drug Compatibility
Refers to the chemical stability of two or more IV medications when administered
together
When administering two or more IV medications in one IV line, determine the
compatibility of each medication with the other
Managing Incompatibility
Too many IV medications ordered
Limited number of IV access ports
Resolution:
Stagger IV medications
Flush IV line with normal saline solution
Suggest central line
Premedication Assessment
Reduces risk of adverse events
Provides baseline for evaluating IV medication intervention
Review: health history (esp allergies and labs), medication data
(contraindication), vital signs, physical assessment (check IV site for redness or
drainage), client’s learning needs
Reconstitution and Labeling of Drugs
Reconstitution: done with powdered meds.
Common diluents
Normal Saline (0.9%)
Sterile Water for injection
Dextrose 5% in water
Some medications in double chambered vials (one with powder, one with
diluent)
Solution containers must be labeled:
Client’s name, room number, date, and name & amount of solution and
medication, expiration date and time, initials or name of RN giving the meds
Client Teaching
Name of medication
Desired action
Frequency of administration
Possible adverse effects
Report pain or swelling at or distal to IV insertion site
Documentation
Med, dose, route, if bolus, push or piggy back, time, signature, if med is
withheld or refused, document this and the reason in the MAR and add a nurses
note. Document clients response to med, appearance of IV site before, during
and after admin., amount and type of fluid being infused with, if a pump is being
used or gravity, time when infused, flow rate, amount and type of fluid used for
flushing before and after med admin.
Blood Transfusion Therapy (Chapter 40 – pg. 821-827)
Blood Types
oBased on the presence of antigens: ABO system
A antigen (type A blood)
B antigen (type B blood)
Both A and B antigens (type AB blood)
Neither A nor B antigens (type O blood)
O blood type can’t receive any blood but O typeThis study source was downloaded by 100000830212155 from CourseHero.com on 08-13-2021 06:16:36 GMT -05:00
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