RLE

• IV FLOW RATE CALCULATIONIV THERAPY FLUIDS

   

  • will come in sterile plastic bag or glass bottles
  • Physician & health care providers order IV fluids and flow rate
• IV ORDERS

   

  • The prescriber is responsible for writing the order
  • Administering and monitoring an IV is a Nursing Responsibility
• IV ORDER must specify the following:

  1. Name of the IV solution
  2. Name of the medication to be added if any
  3. Amount (volume) to be administered
  4. Time period during which the IV is to infuse
• IV DELIVERY METHODS

   CONTINUOUS

   

  • Replace or maintain fluids and electrolytes
  • Flows continuously

   

  INTERMITTENT

   

  • IV piggy back
  • Used to administer medications and supplemental fluids
• MICRODRIP AND MACRODRIP

  
• MICROSET = MICRODRIP

  
• MACROSET= MACRODRIP

  
• BLOOD = WITH FILTER

  
• REGULATION OF IV DRIP RATE MANUALLY

   

  • TUBING for these sets contains a roller clamp
  • Can open or close and regulate rate manually
  • Use a watch with a second hand to count number of drops per minute in the chamber
• ELECTRIC INFUSION PUMP

  • IV infusion pumps utilized to deliver IV fluids accurately - set as ml/hour
• LABELING IV’s

   

  • Every IV must be labeled so any professional can check:

  The fluid infusing is correct

  The rate of infusion is correct

  • Label:

  Patient Name

  Room/Bed #

  Date & Time

  IV Order
• FORMULA FOR HOURLY RATE

  
• FORMULA FOR CALCULATING DROPS PER MINUTE (GTTS/MIN)

  
• FORMULA FOR MICRODROPS PER MINUTE (UGTTS/MIN)

  
• IV COMPLICATIONS

   INFILTRATION

  EXTRAVASATION

  PHLEBITIS
•  INFILTRATION

   

  • Infiltration is the accidental leakage of non-vesicant solutions out of the vein into the surrounding tissue. This can occur with many antibiotics, dextrose solutions, or even normal saline.
  • When left unchecked and untreated, IV infiltration can result in pain, swelling, compartment syndrome, and even amputation of the affected limb
• EXTRAVASATION

   

  • When the leaked solution from an infiltration is a vesicant drug—one that causes tissue injury blisters or severe tissue damage—it is referred to as an extravasation.
  • Injuries from this type of IV failure can be severe and can lead to the loss of function in an extremity, and if the damage is severe enough, tissue death—known as NECROSIS
• PHLEBITIS

   

  • inflammation of the vein which is caused whenever the used cannula is too large for the chosen vein, or when the cannula is not secured in place
• FOOD AND DRUG ADMINISTRATION

   

  • the agency responsible for licensing, monitoring and regulation of cosmetics, drugs, foods, household hazardous products, medical devices, vaccine and related products for safety, efficacy and quality in the PH
  • the RA no. 9711 otherwise known as "The Food and Drug Administration Act of 2009" requires that labels be accurate and that all drugs be tested for harmful effects

   

  • Another aspect of nursing practice governed by law is THE USE OF CONTROLLED/REGULATED DRUGS
• PRINCIPLES OF MEDICATION ADMINISTRATION

  
  

  • Practice Asepsis
  • 10 Rights of medication administration
  • Nurse who administers the medication is responsible for their own action
  • Be knowledgeable about the medication that you administer
  • Keep the narcotics in locked place
  • Use only medications that are in clearly labeled containers
  • Return liquid that is cloudy in color to the pharmacy
  • Before administering medication, identify the client correctl
• RIGHT MEDICATION

   

  • The medication given was the medication ordered. THE NURSE DOES THIS 3 TIMES-CHECKING

  o   Before removing the container from the drawer or shelf

  o   As the amount of medication ordered is removed from the container

  o   Before returning the container to the storage
• RIGHT DOSE

   

  • The dose ordered is appropriate for the client. Double check calculations that appear questionable
•  RIGHT TIME

   

  • Give the medication at the right frequency and at the right time ordered according to agency policy.
• RIGHT ROUTE

   

  • Give the medication by the ordered route. Make certain that the route is safe and appropriate for the client
• RIGHT CLIENT

   

  • The medication is given to the intended client. Ask the client’s name and check the client's identification band with each administration of a medication
• RIGHT CLIENT EDUCATION

   

  • Explain information about the medication to the client (why receiving, what to expect, any precautions)
• RIGHT DOCUMENTATION

   

  • Document medication administration after giving it not before. Follow agency policy
• RIGHT TO REFUSE

   

  • Adult clients have the right to refuse any medication. The nurse's role is to ensure that the client is fully informed of the potential consequences of refusal. Communicate the client's refusal to the AP.
• RIGHT ASSESSMENT

   

  • Some medications require specific assessments prior to administration. Medication orders may include specific parameters for administration
• RIGHT EVALUATION

   

  • Conduct appropriate follow-up (desired effect or experienced any side effects or adverse effects
• NURSES NEED TO:

   

  • know how nursing practice acts in their areas define and limit their functions
  • be able to recognize the limits of their own knowledge and skill.
  • Under the law, nurses are responsible for their own actions regardless of whether there is a written order.
  • Nurses should question any order that appears unreasonable and refuse to give the medication until the order is clarified.
• ROUTES OF ADMINISTRATION

   

  ORAL ADMINISTRATION

  SUBLINGUAL ADMINISTRATION

  BUCCAL ADMINISTRATION

  TOPICAL ADMINISTRATION

  PARENTERAL ADMINISTRATION

  OPHTHALMIC MEDICATION

  OTIC ADMINISTRATION

  NASAL ADMINISTRATION

  RECTAL ADMINISTRATION

  VAGINAL ADMINISTRATION

   
• SOLID - tablet, capsule, pill, powder

  • use pill cutter in cutting tablets
  • NEVER CRUSH ENTERIC COATED OR SUSTAINED RELEASE TABLET
• Crushing enteric-coated tablets - allow the irrigating medication to come in contact with the oral or gastric mucosa, resulting in gastric irritation

  Crushing sustained-released medication - allows all the medication to absorbed at the same time, resulting in a higher-than-expected initial level of medication and a shorter than expected duration of action
• LIQUID - syrup, suspension, emulsion, elixir, or other alkaline substances

  • Syrup - sugar-based liquid medication
  • Suspension - water–based liquid medication shake bottle before use of medication to properly mix it
  • Emulsion – oil-based liquid medication
  • Elixir - alcohol-based liquid medication after administration of elixir allow 30 mins to elapse before giving water. This allows maximum absorption of the medication
• SUBLINGUAL ADMINISTRATION

   

  • A drug that is placed under the tongue where it dissolves
  • A medication by the sublingual route should not be swallowed, or desire effects will not be achieved
• BUCCAL ADMINISTRATION

   

  • A medication is held in the mouth against the mucous membranes of the cheek until the drug dissolves
• NASOGASTRIC TUBE

   

  • inserted by way of nasopharynx and placed into stomach

   

  GASTROSTOMY TUBE

   

  • surgically placed directly into the client’s stomach and provides route for medication and nutrition
• TOPICAL ADMINISTRATION

   

  • are those applied to a circumstances surface area of the body
• TOPICAL MEDICATION: applied locally to the skin/ mucous membrane

  Percutaneous: applied to intact skin

  Transdermal patch: administers sustained action medications via multilayered films containing drug and an adhesive layer

   

  DERMATOLOGIC PREPARATIONS - applied to skin

  INSTILLATIONS AND IRRIGATION - applied to body cavities/ orifices

  INHALATIONS administered into the respiratory tract by nebulizer circumstances surface area of the body