12/29/13

Administering Blood and Blood Products

Administering Blood and Blood Products Equipment ■ Clean nonsterile gloves. ■ Blood product. ■ 250 mL normal saline IV solution. ■ Blood administration set with a 200-micrometer filter and Luer-Lok connection (if there is no filter on the tubing, you must attach one). ■ Be Smart! Although nurses commonly use a 20-gauge catheter, for routine transfusion, a 22- or 24-gauge can be used. You would need an 18- or 20-gauge catheter to transfuse large amounts of blood rapidly. ■ Be Smart! When choosing an IV catheter for transfusion,...
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Discontinuing a Peripheral IV

Discontinuing a Peripheral IV Equipment ■ Clean nonsterile gloves, sterile 2 in. 2 in. gauze dressings. ■ 1-in. tape or transparent semipermeable dressing. ■ Linen-saver pad. Assessment ■ Verify the order and assess the patient’s readiness to have the IV fluid discontinued (e.g., tolerating oral fluids, has adequate urine output, laboratory...
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Converting a Primary Line to a Heparin or Saline Lock

Converting a Primary Line to a Heparin or Saline Lock Equipment ■ Clean nonsterile gloves. ■ Peripheral intermittent lock adapter. ■ 2 syringes containing saline or dilute heparin solution. ■ Linen-saver pad. ■ Transparent semipermeable dressing. ■ Alcohol or other antiseptic swab. Assessment ■ Assess the patient’s readiness to have the...
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Changing IV Dressings (Central Line Dressings)

Changing IV Dressings (Central Line Dressings) Equipment ■ Clean nonsterile gloves. ■ Central line dressing kit (including sterile gloves, mask, sterile transparent semipermeable dressing, sterile tape, an antimicrobial agent, and a sterile catheter stabilization device). ■ Mask for patient. ■ A sponge containing the antimicrobial agent CHG may be used as a part of the dressing, as well. ■ Note: You can use povidone-iodine followed by alcohol as the antimicrobial if CHG is contraindicated and if the patient is not allergic...
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Changing the IV Solution and Tubing

Changing the IV Solution and Tubing Equipment ■ Nonsterile gloves. ■ Administration set. ■ IV solution. ■ IV pole. ■ Antiseptic swabs that contain solutions such as alcohol or CHG. ■ Be Safe! CHG is not recommended for infants younger than age 2 months. ■ 1-in. nonallergenic tape. ■ Time tape. ■ Watch with a second hand or digital readout. Assessment ■...
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Initiating a Peripheral IV Infusion

Initiating a Peripheral IV Infusion Equipment ■ IV solution. ■ Administration set or IV lock and injection caps. ■ IV catheter. ■ If using extension tubing, a saline-filled syringe to prime it. ■ Procedure gloves. ■ Scissors. ■ Antiseptic swabs containing CHG or 70% alcohol wipes. ■ Tourniquet (nonlatex, if available). ■ Sterile catheter...
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Administering Medication through a Central Venous Access Device

Administering Medication through a Central Venous Access Device Equipment ■ Syringe appropriate for medication volume; needleless device or safety syringe with a filter needle for drawing up the medication. ■ 2 syringes for the flush solution. ■ Saline or heparin flush solution, as prescribed. ■ Alcohol prep pad or CHG-alcohol combination...
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Administering Medication by Intermittent Infusion (Piggyback Set)

Administering Medication by Intermittent Infusion (Piggyback 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...
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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. ■...
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Administering IV Push Through an IV Lock with IV Extension Tubing

Administering IV Push Through an IV Lock with IV Extension Tubing Equipment ■ Correct-size syringe for measuring medication. ■ Needleless access cannula or safety needle. ■ Antimicrobial swabs. ■ IV extension set. ■ Labels for the IV tubing and medication administration system. Assessment ■ Check the site for redness, swelling, tenderness,...
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Adding IV Push Medications Through an Infusing Primary IV Line

Adding IV Push Medications Through an Infusing Primary IV Line Equipment ■ Syringe appropriate for medication volume and the type of line (e.g., peripheral IV, PICC, etc.) ■ Alcohol prep pad, or CHG-alcohol combination product and gauze pad. ■ Procedure gloves. ■ If you are administering through an intermittent device: ■ Two 5- to 10-mL...
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Adding Medication to an IV Infusion

Adding Medication to an IV Infusion Equipment ■ Prescribed IV solution. ■ Syringe for medication. ■ Needleless access device or safety needle (if a VAD is not available). ■ Alcohol or CHG-alcohol prep pad. ■ Label with medication, dose, date, time, and your initials. Assessment ■ Assess the patency and appearance of the IV site. ■ Be Safe!...
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Using a Prefilled Cartridge and Single-Dose Vial for IV Administration

Using a Prefilled Cartridge and Single-Dose Vial for IV Administration Equipment ■ Medication-prefilled cartridge. ■ Alcohol prep pad or CHG-alcohol product. ■ Syringe of the appropriate size for medication volume and viscosity. ■ Filter needle. ■ Safety needle. Assessment ■ Check that prefilled syringe is intact, and that the medication...
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Intramuscular Injection Z-Track Method

Intramuscular Injection Z-Track Method Equipment ■ Syringe and needle appropriate for volume and site. ■ Alcohol prep pad or CHG-alcohol product. ■ Gauze pad or adhesive bandage. ■ Medication. ■ Procedure gloves. ■ Biohazard (sharps) container. ■ Small piece of gauze or cotton ball. ■ Small adhesive bandage. Assessment ■ Identify the site...
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Locating Intramuscular Injection Sites

Locating Intramuscular Injection Sites Assessment ■ Be Safe! Always palpate the landmarks and the muscle mass to ensure correct placement of the needle. Key Points Ventrogluteal Site ■ Ask the patient to assume a side-lying position with the legs straight, if possible. Alternatively, use a supine position. ■ On adults, the site is a triangle...
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