IV push

[greyL]

In school I was taught to dilute IV push medication with saline, but my preceptors have told me this isn't necessary. Which is correct? Also, the couple of times that my preceptor has been with me while pushing meds, she made me feel rushed! How much time do you need to push narcotics and things like protonix? =/

[LadyFree28, BSN, LPN, RN]

Doh, you're totally right. We have a replacement protocol and it's given piggy back and diluted with IVF and it still burns like a mofo.

Yeah...even with a liter bag...being the "wonderful" nurse patient that I am; I kept requesting for K+ by mouth; had to turn the pump off for my nurses to get the message...being on the receiving end of feeling like your arm is on fire is NOT fun...

[Novo]

A prison executioner

[Morainey, BSN, RN]

I always check our IV med book. Our pharmacy also made a "Common IV Meds" binder for a quick reference.

[KelRN215, BSN, RN]

IV push medication is administered over the amount of time that was ordered.

I feel that any medication needs to be diluted , in order to administer it over the prescribed time frame.

They don't need to be. I push methotrexate multiple times a week. Depending on the infusion pharmacy it may be supplied in 10 mL normal saline, 2 mL normal saline or not diluted at all. I work with children who are getting relatively small doses in the 15-30 mg range. It comes in 25 mg/mL. I have no problems pushing it over 3-5 minutes regardless of how it is supplied. And I'm certainly not going to take it upon myself to dilute chemotherapy in someone's home.

There are, in fact, many medications that you are NOT supposed to dilute. IV Valium crystalizes as soon as you try to dilute it.

[AFhopeful]

There are, in fact, many medications that you are NOT supposed to dilute. IV Valium crystalizes as soon as you try to dilute it.

Learned this the hard way in a patient's room after I had been told in nsg school by an older nurse to dilute everything!! So glad the valium crystalized on me right away and I was like uhhh that doesn't look right.

Now I look up EVERYTHING just to make sure, and even when I have abx/other Iv meds running I look up whether meds can be given with whatever is running. IV acetaminophen for example!!

[Asystole RN]

Every push medication is different.

If possible, it is best to dilute the push medication as much as possible with the compatible solution that suits the intended purpose. The main reason for this is to achieve a greater control over the push time and to achieve greater hemodilution. Not all medications should be diluted nor are compatible with saline.

That single layer of epithelial cells in the tunica intima does not generally like super concentrated medications.

AsystoleRN, BSN, RN, CRNI, VA-BC

[MendedHeart]

IV push medication is administered over the amount of time that was ordered.

I feel that any medication needs to be diluted , in order to administer it over the prescribed time frame.

We do not have ordered amounts of time to push IV meds or on all piggybacks

The correct thing to do is to look it up in the reference book supplied and approved by the facility. I am not sure why there is so much back and forth. The answer is to look it up, I dont listen to what anyone else tells me if im unsure of things, I look it up.