eSign Camper Medication Administration Made Easy

Esign camper medication administration

all right today we're going to be doing IV medications so this will incorporate IV piggyback so adding a secondary medication to a smaller bag of fluid as well as IV push medication if you're an LPN student you will only need to latch the IV piggyback portion and then you can stop if you are an RN student you will want to watch both portions IV piggyback and IV push so first we'll start with the IV piggyback for this skill the supplies that you are going to need are a 50 ml bag of fluid a bottle of medication or a vial of medication a three ml syringe with needle secondary tubing and your medication labels so first we'll check our M AR and these will be in all of the medication rooms as well as in the ID room so that you can check them first we can see that our patient has a running IV of 0.9% sodium chloride at 75 ml an hour so I do have that already infusing the next line down is our capsule or cefazolin 250 milligrams per ml and 50 milliliters 0.9% sodium fluoride and our order is to give 250 milligrams and 50 MLS at 100 ml per hour IV piggyback every eight hours so we'll check our bag of fluid we have 50 ml of 0.9% sodium chloride and then we have our vial which is capsule or cefazolin 250 milligrams and one ml I'm going to draw up the medication first we'll check them are again capsule 250 milligrams per ml checks all 250 milligrams per ml so I'm going to drop one milliliter and we'll scrub the top of the vial for 15 seconds and then this will be just like when you did your injection skill you'll draw out your medication and you want to make sure that you are free of air bubbles and then I'm just going to we'll check this again we have 50ml of 0.9 percent sodium chloride 50 ml 0.9 percent sodium chloride on your bag you want to make sure that you check the expiration date to make sure that it's not expired so this is March of 2023 you also want to make sure that it's clear there's no particles in it I like to take an extra or another alcohol to wipe and clean this port so there's two ports on these the one that has the blue tab this is the one that we will spike our tubing in your other one is the port that you will inject the medication in so just clean this for 15 seconds and then you will take your needle and syringe and just inject it right into the middle that can just go straight into the cars and then we want to gently rock this back and forth and then I have a medication label already prepared with a patient's name the drug we have caps all 250 milligrams and 50 milliliters of 0.9 sodium chloride and we'll want to fix that to the back of the bag so that it does not cover the front of it all right now we're ready to prime our tubing there is usually a perforation on your secondary to be your secondary tubing is much shorter than your primary tubing the Alerus tubing that I have this hooked up right now to is a hundred and sixteen inches where our secondary tubing is 37 inches so quite a bit shorter I'm do our to you and you can stretch out your tubing make sure you move your roller clamp and then also close it now there are two ways to prime your tubing you can direct Prime your tubing which would be just like if you were priming a normal primary infusion so your sodium chlorite you'd spike the bag and then just prime it with that though you do have to be careful because you don't want to lose medication so you have to kind of prime slowly another way to do it is to back flush or back prime so I can show you both ways the spike of our tubing that needs to be kept sterile and then we're going to pull off this blue tab and these you kind of have to push and twist and then I'll fill the drip chamber so if we're going to direct crime at we can just come over to the sink and slowly crime so I did that without wasting any of the medication the other way back flushing or the priming you will need another alcohol white and we're going to go to the highest port on our eye a tubing so that would be the port that is closest to your primary to being stripped chamber scrub that port for 15 seconds as well and then we will lower lock our secondary tubing onto that pork and then you are primary tubing will need to be on like the roller clamp will need to be on client and then you can unclamp your roller clamp on your secondary to thee so because I've already primed this it's going to be a little bit different than what it would be if you just have secondary two beads that you attached straight to here there wouldn't be any fluid in it if you had just taken your secondary tubing out of the bag but watch the drip chamber as I undo the roller clamp here you'll need to hold it lower than your primary you can see that it's spinning we'll just let these air bubbles come back up here okay you can kind of see if you get too much in your drip chamber you can't invert your bag and give it a little squeeze just like though with a directive I mean you do need to be careful so that you don't overfill your drip chamber with your primary fluid so that your drug concentration is not altered so either way is acceptable and you'll be able to practice both ways as well so then if this point we can add our tubing change sticker as well and then your secondary tubing will come with a blue pin there that we're gonna lower our primary fluid to if you were running an infusion strictly on gravity it's very important that your medication that you're infusing first which would be our piggyback would need to be higher than your primary if you're running it on an IV infusion pump it'll depend on the pump sometimes it doesn't matter whether or not you have to lower it most nurses and most facilities that I've been to you're still going to see nurses lowering now okay and then you would set your IV infusion pump appropriately or you would figure the drip factor based on your rate which is 100 MLS per hour with IV piggybacks we do also need to make sure that what we're going to infuse is compatible with what's currently infusing you can find my information and a drug book or some facilities also have a any compatibility chart so either one would give you that information that you need and that will complete the ID piggyback portion so if you're an LPN student you may stop watching now okay now we're going to move to the IV push so IV push is a very direct way to give medications to your patient it's very effective but it's also dangerous what we're putting in is going straight into the vein and I mean the side effects can be almost immediate so we do need to watch her adverse reactions we'll go ahead and check our Mar so for this patient our order is to give morphine sulfate we have a concentration of 4 milligrams per ml and the physician has ordered for us to give 2 milligrams IV push every four hours as needed for severe pain so you would do your pain assessment you know ask the patient if they want pain medicine and then we could do that so for this particular medication we're going to give half of an ml so for this skill there's two ways that it can be done you can administer the IV push medication via a saline lock which is what you see here or you could also administer it via a running infusion and I'll talk about both ways for you so you're going to need a vial of morphine and three ml syringe with needle and two saline flushes especially if you're going to do the saline lock administration as well as a drug book so we'll check our medication we have morphine sulfate two milligrams oh this is our Mara's Rama net so what are you gonna do Aaron well I am I would have to clarify the order with the physician so if I'm gonna go by the vial this says two milligrams per 1 ml we are ordered to give two milligrams IV push so I will give one ml based off of that but I would call the physician to clarify so we've checked our bar this once again is just like drawing up a medication current injection clean your vial for 15 seconds all right so once again morphine two milligrams per 1 ml and we're ordered to give two milligrams so I will draw up one of them and I will scoop I can't back on so if you're going to give if you have a running infusion let's start with that first once again you also need to make sure that what you are going to administer is compatible with what is currently administering so find that information in a drunk book or the compatibility chart depending on the type of tubing that you have at your facility what I normally do is I go to the the white port that would be closest to the patient that's on the primary tubing you could this is a needle port here so that will not work with what we are going to do because we're going to lure lock so we would scrub this hub for 15 seconds okay and then I like to kink off the tubing you can pause your IV pump as well whatever your facility recommends and then we would the purpose of your drug book is that we need to know how fast we can push this medication so you would look up morphine in your drug book and it should tell you a rate whether it's one milligram a minute that's the priests standard rate so we're giving two milligrams so we would and push this over two minutes which I'm not going to push this but I will in the ceiling lock one so you would lure lock this on have this kinked in your IV pump paused and then over two minutes slowly infuse this what I do is I divide my amount basically every thirty seconds I would give so much okay and then once you're done you can unlock that restart your pump for the saline lock I'm going to get the air out [Music] if you pull back on your plunger that will release the pressure instead of pushing up and then it will squirt all over make sure your air bubbles are out so this saline lock that this patient has has two ports it doesn't matter whichever you use we'll just use the one on the right here so we're going to clean our port for 15 seconds I'm going to unclamp this here I like to check for a blood return we have blood so then we will flush with whatever your facility recommends usually two to three MLS so there is three and then we'll clean our port again for 15 seconds and now we're ready to do our medication so then I would watch either a clock in the room or a watch and slowly infuse this over two minutes okay let's say it's been two minutes clean our port again and you're going to take your other flush syringe and attach it to your fort and then once again flush with two to three MLS or whatever your facility recommends and that's usually just a slow push and then we will clamp our ceiling lock and then we do need to stay with our patient to observe for any adverse reactions because it is going directly into the patient's bloodstream so then if it's a pain medicine you would come back and reassess in 30 to 60 minutes depending on your facility's protocol so that concludes the IV piggyback and the IV push scope session