Administering Medication by Intermittent Infusion Using a Volume-Control Administration Set

Administering Medication by Intermittent Infusion Using a Volume-Control Administration Set

Equipment
■ Correct-size syringe for measuring medication.
■ Needleless access cannula or safety needle.
■ Small bag of diluted medication with piggyback tubing.
■ Primary IV solution and tubing (unless one is already infusing).
■ Antimicrobial swabs.
■ Labels for the IV tubing and medication administration system.

Assessment
■ Check the site for redness, swelling, tenderness, and other signs of infiltration or phlebitis. Post-Procedure Reassessment
■ Assess for complaints of pain or discomfort at the site.
■ Be Smart! Intermittent infusions are generally administered over 15 to 60 minutes, so you need to assess the patient as soon as the infusion begins and every 15 to 20 minutes until it is absorbed.
■ Assess for factors that will provide a basis for evaluating the drug’s effectiveness, such as checking BP after administering an antihypertensive agent.

Key Points
■ Be Safe! Ensure the compatibility of the IV solution and medication.
■ Be Smart! Be sure you have the correct tubing.
■ Be Smart! Calculate the amount of medication to add to the solution.
■ Use the correct amount and type of diluent solution.
■ Be Safe! Use the correct rate of administration.
■ Close both the upper and lower clamps on the tubing.
■ Open the clamp of the air vent on the volume-control chamber.
■ Maintaining sterile procedure, attach administration spike of the volume-control set to the primary IV bag.
■ Fill the volume-control chamber with the desired amount of IV solution; then close the clamp.
■ Prime the rest of the tubing.
■ Scrub all surfaces of the injection port closest to the patient using an antiseptic swab.
■ Connect the volume-control tubing to the extension tubing.
■ Scrub the injection port on the volume-control chamber; attach the medication syringe using a blunt, needleless device; and inject the medication into the solution in the chamber.
■ Gently rotate the chamber to mix the medication in the IV solution.
■ Open the lower clamp, and start the infusion at the correct flow rate.
■ Be Safe! Affix the correct label to the secondary bag, identifying the infusate, patient name, start date and hour, discard date and hour, and your initials.

Documentation
■ Record the appearance of the IV site and patient complaints of pain or discomfort during IV administration.
■ You will usually document on an IV flow record and/or MAR rather than in the nursing notes.
■ Chart a nursing note only if there is a problem (e.g., if the patient experiences pain when you administer the medication).

Adding medication to the volume-control chamber