IV push

  1. 0 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? =/
  2. Visit  greyL profile page

    About greyL

    Joined Feb '11; Posts: 86; Likes: 29.

    54 Comments so far...

  3. Visit  nurs1ng profile page
    0
    I prefer to dilute my IV narcotics with NS especially for patients who want it ON THE DOT... you never know when you're pushing too fast.

    Oh, and I would go with what school taught you. Some nurses out there aren't up to date with latest evidence based practices. Just an FYI.
  4. Visit  WAheartnurse profile page
    0
    The only thing I feel comfortable not diluting are things that come in a carpuject- obviously they are meant to be pushed without dilution. Even so, you avoid a lot of problems by diluting meds out, they just don't seem to hit the patient as hard. I was hospitalized a while ago and got 2mg of morphine pushed and I thought the bed had dropped out from me- I hated that feeling! With the carpuject you really cannot push very slowly really because the med just fills up the saline lock because it is such a small amount of volume and then when you flush it- the med hits them all at once.
  5. Visit  Been there,done that profile page
    0
    Where are you practicing?

    Each and very drug has a prescribed diluent and administration rates.It's mpossible to administer anything directly out of the vial.

    Narcotics especially ,are titrated to nursing observation of the response to the medication.

    Report this joint.
  6. Visit  Nursetastic profile page
    0
    I dilute pretty much everything, especially if pushing through a PIV. If a patient has a central line or PICC there is no worry about irritation of the vein but you don't want adverse affects from pushing too fast either. Think about what the med is for; narcotics, beta blockers, benzos...all can have adverse effects on vital signs or clinical status so push slowly no matter what. Also, it's easier to do a slow push if you have diluted the med into a 10cc syringe; you can control it much better.
  7. Visit  VANurse2010 profile page
    9
    Quote from Been there,done that
    Where are you practicing?

    Each and very drug has a prescribed diluent and administration rates.It's mpossible to administer anything directly out of the vial.

    Narcotics especially ,are titrated to nursing observation of the response to the medication.

    Report this joint.
    Many meds can be given without diluting. I find this reply very odd.
  8. Visit  klone profile page
    0
    In OB, we push narcs all the time without diluting - Fentanyl, Nubain, Morphine. Into saline locks, then pushed through with a flush. Of course, if it's a running IV, it will automatically be diluted by the line.
  9. Visit  ChristineN profile page
    0
    Quote from Been there,done that
    Where are you practicing?

    Each and very drug has a prescribed diluent and administration rates.It's mpossible to administer anything directly out of the vial.

    Narcotics especially ,are titrated to nursing observation of the response to the medication.

    Report this joint.
    What if you are doing something like say conscious sedation? You may actually prefer to give something undiluted so the pt becomes unconscious sooner.

    Also, there are certain drugs, like Zofran, that I see nurses dilute all the time that if you look it up in a drug guide actually does not require dilution.
  10. Visit  MyUserName,RN profile page
    0
    I dilute almost everything. It's just easier all around IMO and better for the pt too.
  11. Visit  VANurse2010 profile page
    2
    Quote from MyUserName,RN
    I dilute almost everything. It's just easier all around IMO and better for the pt too.
    I only dilute if it's absolutely necessary. I haven't killed, maimed, or harmed anyone.
    hiddencatRN and kcochrane like this.
  12. Visit  MendedHeart profile page
    6
    I look every IVP up in drug guide.for rate of push and dilution. Safest method.
    Anna Flaxis, nurseladybug12, AJJKRN, and 3 others like this.
  13. Visit  MunoRN profile page
    7
    Most medications don't actually need to be diluted beyond the concentration it is supplied in. Diluting medication unnecessarily provides no benefit, but it can cause harm, which is why the ISMP discourages unnecessarily diluting meds due to contamination risks, labelling error risks, and potentially giving incorrect doses.
    Spidey's mom, KelRN215, hiddencatRN, and 4 others like this.
  14. Visit  0.adamantite profile page
    0
    I like to dilute medications as well but I read an article by the ISMP (?) that states that you should not draw up medications from carpujet containers, which are not intended to be punctured by a needle/syringe.


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