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CONCEPT: INFECTION/INFLAMMATION
IV PUSH MEDICATION
1. What is an IV push medication?
An IV push medication is a medication that can be administered through a venous access device
that is being used for continuous infusion of fluid. This is a single injection of concentrated
solution directly through an IV access.
2. Why give a medication IV push?
When medications are given through an IV push, they can be rapidly absorbed. This also helps
the medication to stay more potent since the medication doesn’t have to go through the
digestive tract.
3. What safety checks are required prior to administering an IV push medication?
Safety checks that are required prior to administering an IV push medication are right patient,
right route, right time, right medication, right dose, medication is being used prior to expiration
date, and checking to make sure the patient has no allergies to the prescribed medication.
4. What are signs of inflammation and infiltration according to your hospital criteria?
When a patient has inflammation, the site will be red and warm. It will also have some pain and
tenderness. If the patient has infiltration, the site will blanch and be cool to the touch. The
patient will also experience some pain.
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CONCEPT: INFECTION/INFLAMMATION
IV PUSH MEDICATION
5. Discuss how you would administer an IV push medication. At what rate is the flush after the
medication administration given?
To administer an IV push medication, you would start by making sure your hands are clean and
you have a new clean pair of gloves on. The you would prepare the medication and complete
your rights of medication. After that, clean the port with an alcohol wipe, inject the port with a
10mL saline flush. Then disconnect the flush, clean the hub with another alcohol wipe. Attach
the medication to the hub and inject the correct ordered medication. Disconnect the
medication and clean the hub again with another alcohol wipe. Attach another saline flush and
flush the port with 10mL of saline.
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CONCEPT: INFECTION/INFLAMMATION
IV PUSH MEDICATION
6. These pictures identify 3 routes for administering IVP medications.
a. IV solution is hanging and running
b.
1 available port with PICC
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c. Heparin lock
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CONCEPT: INFECTION/INFLAMMATION
IV PUSH MEDICATION
How would you administer an IV push medication using each option? Identify the steps.
a. For the IV solution that is hanging and running, you would need to locate the port that is
closest to the insertion site. You then need to make sure to clean the port with an
alcohol. Use a 10mL saline flush and reclean the port. You need to check the rights of
the medication and identify the correct patient. Then you need to clamp the IV, attach
the medication to the port and inject the medication. When the medication is
completely administered, remove it and clean the port again. Then use a 10mL saline
flush at the same port. Clean the port again and unclamp the tube.
b. For the 1 available port with PICC, you need to clean the port with an alcohol wipe.
Complete the rights of medication and confirm the right patient. Then flush the tubing
with a 10mL saline flush. Remove the flush and clean the port with an alcohol wipe.
Then attach the medication to the port and inject the medication. Remove the
medication and clean the port with another alcohol wipe. Attach another 10mL saline
flush and inject. Remove and clean the port with another alcohol wipe.
c. For the heparin lock, you need to clean the port with an alcohol wipe after confirming
the rights of medication and the correct patient. You then flush the tubing with a 10mL
saline flus. Remove the flush and clean the port again. Then attach the medication and
inject it into the port. Once finished, remove and clean the port again. Then you need to
attach a 10mL Heparin flush and inject. When that is done, remove and clean the port
again. Make sure to flush at the end with a Heparin flush instead of saline.
7. How many ml of NSS is used to flush a peripheral IV and a PICC line?
You would use 10mL as a minimum amount to flush with.
8. What method is used to flush a power PICC ?
When flushing a power PICC, you need to use a method called the “push and pause”
method. This is when you inject 1 to 2 mL of Heparin and have a pause, and keep repeating
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IV PUSH MEDICATION
the process until all of the medication has been injected. This is done to help the catheter
from occluding.
9. What is the nurse to do if there is no blood return prior to the initial line flush for a
peripheral line? A Central line (PICC)?
The nurse needs to check for signs of infiltration or extravasation and see if the patient has any
irritation. Always check the tubing for any closed clamps or kinks that may have formed in the
line. If the nurse still is unable to get a blood flash or flush the line, then the nurse needs to
remove and insert a new IV. When the nurse is working with a central line, the nurse needs to
check for any occlusion of the line and attempt to flush it with a Heparin flush. If the nurse can’t
get a blood return, then they need to contact the provider. The provider will then evaluate the
line and see if it needs to be removed and a new on inserted.
10. Can the administration of IV push medications be delegated?
No, the administration of IV push medications can’t be delegated.
11. Prior to administering an IV push medication, you assess the patient’s IV. The IV cannot be
flushed and the patient tells you his IV “hurts.” How would you proceed?
I would first begin by inspecting the Iv site. I would look for signs of infiltration or inflammation.
If everything looks good, I will attempt to continue with the medication. If the line appears to
have moved or not be in working order, I will remove the IV, and start a new line.
12. Complete ATI medication templates for the following medications and bring to lab.
Metoclopromide
Ondansetron
Lorazepam
Morphine
Furosemide
Dexamethasone
Pantroprazole
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IV PUSH MEDICATION
Make note of rate of administration, dosage(for IVP) and if medication requires
dilution for each via the IV Push route.
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