Diluting all IV push medication??

[srewer]

I had a nursing instructor tell a nursing student that "you must dilute all IV push medication with at least 10cc NS." I know that there are medication that must be diluted, but not all? I have not been able to find this standard in AL's nursing standards, just wanted to see if anyone knew of this being a nursing standard in your state and if so, where I could find information on the rationale. I think it could be a great implementation at my hospital, but first must find the evidence to back the idea. Thanks

[daisybaby, LPN]

Adenocard is one that is never, ever diluted. It's given as a rapid (like as fast as you possibly can) IVP followed by a fast NS 10cc flush. Adenocard's half-life is a few seconds, so you need to get it to the heart super fast and undiluted if it's going to do any good.

[kmoonshine, RN]

Adenocard is one that is never, ever diluted. It's given as a rapid (like as fast as you possibly can) IVP followed by a fast NS 10cc flush. Adenocard's half-life is a few seconds, so you need to get it to the heart super fast and undiluted if it's going to do any good.

Agree with the above. Also, valium shouldn't be diluted (although I think I stated that in an earlier post).

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[blinks14]

I am a new graduate and I was never taught to dilute every single IV Push. We always looked whatever we were to give via push and gave it according to the drug book directions. Also as far as the Phenergan goes at my facility it must be diluted in at least a 50cc mini bag prior to administering.

[iluvivt, BSN, RN]

Not all IV medications need to be diluted. The best practice is to look up the drug and follow the manufactures recommendation. Contrary to popular belief there are many drugs that are inherently irritating and no matter how much you dilute them ,it will make no difference in vein preservation or protection. Also be aware that there are a handful of drugs that can only be mixed with D5W.

[dialysispt]

I go to dialysis and often receive benadryl. Should it be diluted? Some nurses do and others don't. I feel like it does not work as well when it has been diluted. I thank you in advance for your time.

[dialysispt]

You mentioned that you use benadryl for patience that feel like they want to jump out of their skin. I get that feeling when I am on the dialysis machine. Because of this feeling, I am given benadryl. When it is administered, some nurses dilute it while others do not. I wonder if it should be diluted. I know it does not feel like it is working well when it is diluted compared to when it isn't diluted. So, should it be diluted? I thank you in advance for your time.

[LouisVRN, RN]

I dilute almost all of the medications I give IV. Except for Valium, as another poster mentioned and anything needing to be given STAT, like Ativan in a pt that is seizing. I find that a lot of time people won't feel as immediate effects of medications like Benadryl, Dilaudid, Morphine when they are diluted but they also seem to have less adverse effects, drop in BP, Pulse, Respiration etc. regardless of whether or not they "like it" I do dilute it, they are getting the same dose.

[LouisVRN, RN]

I will never give anything in a port that is not closest to the patient with the exception of possibly a central line. Just in case it is something like Dilaudid and at some point between you injecting it and the patient believing the dose was delivered the line blows.

[mykrosphere]

the only drugs i have ever diluted are protonix (which pharm specifically states to mix with 10 ml of ns) and ativan for im injection (because man that hurts!)

if a drug needs to be diluted, it is usually done so and hung as a piggyback.

100 percent of our antibiotics are hung piggyback.

and 99 percent of our patient population has a picc or central line.

i have never had an issue with not diluting.

but i have heard plenty of complaints about the taste of a saline flush (??)

[mykrosphere]

I go to dialysis and often receive benadryl. Should it be diluted? Some nurses do and others don't. I feel like it does not work as well when it has been diluted. I thank you in advance for your time.

i used to work in dialysis and have never heard of benadryl being given diluted through a line.

[K+MgSO4, BSN]

Paracoxib(dynstat) is a fast IV push and ceftriaxone can be given in 10 ml water push.

Here in Australia we don't get our IVABs pre mixed so it is up to the nurse to read the Australian Drugs handbook to check how each and every IV drug is given.

Also check hospital and ward policy. In ED nurses can push IV morphine but on the wards it has to be given s/c

[krazievi3t6url]

funny, I found this questions.

I was told by an ER nurse today that you can't dilute valium and any code meds! Maybe that is the policy and procedure at that particular hospital, not sure though.