College of Nursing
Adult Health Nursing II
Block 7.0
Topic: IV Medication Administration
Module: 1.2
Block 7.0 Adult Health II
Block 7.0 Module 1.2
 Apply the principles of safe intravenous
medication administration.
 Apply knowledge of dosage calculations to
determine correct medication dosages for
patients.
 Develop an individualized plan for each
patient’s education about intravenous
medication administration.
 Identify nursing responsibilities for the
patient experiencing an adverse drug
reaction
 Manage a patient on multiple IV drugs that
are incompatible
 Demonstrate appropriate documentation.
 Be prepared to discuss key terms.
Block 7.0 Module 1.2
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Extravasation
Vesicant medications
Infiltration
Phlebitis
Thrombosis
Thrombophlebitis
IV Drug Compatibility
Block 7.0 Module 1.2
 Most rapid therapeutic effect
 Can lead to immediate serious reactions
 Nurse must know:
 Drug indications & proper dosage
 Contraindications & precautions
 Appropriate dilution, rate of infusion, pH &
osmolarity, compatibility with other IV
meds
 Never assume that IV administration is the
same as giving the drug by other routes
Block 7.0 Module 1.2
 Six rights of med administration:
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Right drug
Right dose
Right route
Right time
Right patient
Right documentation
 Document on the MAR immediately after giving
 If you did not give the med, indicate on the MAR
& document in the nurse’s notes why you did
not give the med
Block 7.0 Module 1.2
 Do 3 checks on the first 5 rights:
 Check #1: Compare the med label to the MAR as
you remove the drug from the storage area
 Check #2: Compare the med label to the MAR as
you prepare each drug
 Check #3: Compare the med label to the MAR at
the patient’s bedside before you give each drug
Block 7.0 Module 1.2
 Reduces risk of adverse advents
 Provides baseline for evaluating IV med
intervention
 Review:
 Health history  esp. drug allergies & current
labs
 Medication data  contraindications to IV med
 Vital signs
 Physical assessment  check IV site for redness,
swelling, drainage
 Patient’s learning needs
Block 7.0 Module 1.2
 Most IV drug solutions are prepared in the
pharmacy
 If nurse prepares, drug for IV administration,
follow these safety rules:
 Check expiration date
 Maintain sterile technique
 Inspect the drug, dilutent and solution for
particles or cloudiness
Block 7.0 Module 1.2
 Common diluents
 Normal Saline (0.9%)
 Sterile Water for injection
 Dextrose 5% in water
 Some drugs come in double chambered
vials, one with powder, one with diluent
 Solution containers must be labeled
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Patient’s name
Room number
Date
Name and amount of solution and drug
Block 7.0 Module 1.2
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Name of the drug
Concentration of the drug.
Type of diluent used to reconstitute the drug.
Expiration date and time of the drug.
Any other important details - for example, if
there are different reconstitution directions
for IV and IM used, we should indicate
whether the medication is for IM or IV use.
 Initials or name of RN reconstituting drug
(depending upon hospital policy).
Block 7.0 Module 1.2
Block 7.0 Module 1.2
Reconstitute Kefzol
What is the diluent? _______________________
What is diluent volume?___________
What is reconstituted volume?________
What is solution concentration?_______
Block 7.0 Module 1.2
 Severe adverse reactions may occur quickly
 Hypersensitivity to IV drugs can occur
immediately
 The most severe reaction is anaphylaxis
 Dramatic, acute reaction
 Marked by sudden onset of rapid, progressive
urticaria and respiratory distress
 The most common anaphylaxis-causing
drug is Penicillin
 It causes a reaction in 1 to 4 persons out of 10,000
 Is most likely to occur after parenteral
administration
Block 7.0 Module 1.2
Refers to the chemical stability of 2 or more IV
meds when administered together.
IV drug compatibility is defined as:
 No visible or electronically detection of
particulate formation, haze, precipitation,
color change, or gas evolution; and
 Stable (<10% decomposition) for at least 24
hr in admixture
When administering 2 or more IV meds in one
IV line, determine the compatibility of each
med with the other.
Block 7.0 Module 1.2
Compatibility Chart
Block 7.0 Module 1.2
Problems with giving multiple, incompatible IV
drugs on time:
 Too many IV drugs scheduled at same time or
too close together
 Patient has limited # of IV access ports
Resolution:
 Stagger IV drugs for time management 
discuss with pharmacy
 Flush IV line with NS if multiple IV drugs
scheduled close together
 Suggest placement of 2-3 lumen PICC or central
line
Block 7.0 Module 1.2
Medications injected directly into IV port using
syringe.
 USN nursing students can only “push” NS to
flush IV tubing
 As an RN, when giving IV push meds, be
sure to flush the IV line before & after each
med with 10 mL of NS or per facility protocol
Block 7.0 Module 1.2
Med IV Push OR PICC Line Flush
Block 7.0 Module 1.2
Pre-administration, teach patient:
 Name of drug
 Desired action
 Frequency of administration
 Possible adverse effects
 Report pain or swelling at or distal to IV
insertion site
Block 7.0 Module 1.2
 Drug, dose, route (bolus or “push” or piggyback), time, &
signature
 If you withhold a drug or if patient refuses it, indicate this
on the MAR & document the reason in your nurses’ notes
 Patient’s response to the medication
 Appearance of IV site before, during, & after
administration
 Amount and type of fluid to which the medication is
added
 Whether it is being infused by an electronic pump or by
gravity
 Period of time during which the medication is infused
 Flow rate
 Amount and type of fluid for flushing the intravenous line
before and after medication administration
Block 7.0 Module 1.2
Block 7.0 Module 1.2