Should I argue this? about IV push test

**canoehead, BSN, RN** · Oct 9, 2009

Sounds totally correct. In my hospital we've been giving it undiluted since it came out, FYI.

CuriousMe · Oct 10, 2009

Ok so here is my dilemma. I had my skills check off the other day for IV push. The drug I was given was Famotidine 20mg. The med was in 10mg/mL so I was to give 2mL. I looked it up in the medbook and it said "dilute with NS or another compatible fluid 5-10mL". Apparently this means dilute TO 5 or 10mL so that is the total. Well I assumed that meant dilute the 2mL in 5-10mL. So I diluted it to 7mL (2mL of the med, 5mL of NS). To make matters worse, they only supply us with 3mL syringes and obviously you fail if you don't dilute it right. Well I asked for a 10mL syringe so I could dilute it properly and this seemed to **** my teacher off (don't know why...were you trying to trick me?). Anyway, I end up failing the check off because I gave 7mL when, according to them, I should have given 5 OR 10mL based on the diluting rules in the book. Now, in my opinion, this doesn't matter. I still diluted it, gave the correct dose of the med, pushed it over the course of 2 minutes and used the correct diluting solution. If you were me, would you fight this and try to get the fail overturned? Or am I in the wrong?

Hmmm....I'm not a math genius, but it's seems to be that 5 - 10 means between 5 and 10. 5, 10 means 5 or 10. So, it seems to me that 7mL is between 5 and 10.

Also, they only had 3mL syringes but expected you to give 5 or 10mL?

Elvish, BSN, DNP, RN, NP · Oct 10, 2009

It wasn't technically incorrect. I've always given Pepcid diluted up to 10ml but if the book said 5-10, it meant between 5 and 10. It doesn't sound like you did anything wrong.

vmoh18 · Oct 10, 2009

I looked it up in my drug book and according to mine your instructors are right. Here is what mine says.

IV Push:

To prepare famotidine intravenous solutions, aseptically dilute 2mL of famotidine injection (solution containing 10mg/mL) with 0.9% Sodium Chloride Injection or other compatible intravenous solution to a total volume of either 5 mL or 10 mL, and inject over a period of not less than 2 minutes.

If you notice it says to a total volume of either 5mL or 10mL. The only way I would fight it is if you can show that yours says something different

CuriousMe · Oct 10, 2009

Here's what mine says:

Famotidine

IV Administration

Direct IV: Diluent: 0.9% NaCl, D5W, D10W, or LR.Concentration: 4 mg/ml.. Rate: Administer at a rate of 10 mg/min. Rapid administration may cause hypotension.

So, according to this book...it should have been 5mL for 20mg.

OP, what exactly did your drug book say?

Meriwhen, ASN, BSN, MSN, RN · Oct 10, 2009

So I diluted it to 7mL (2mL of the med, 5mL of NS).

That's how I've always given famotidine in school, and I've never been called on it by the instructors. I don't think you did anything wrong either.

Though here is an easier and also correct way, and since it lands on 10mL should satisify your teacher: take your 10mL NS flush, empty 2ml of NS out, inject 2ml famotidine in. Close, invert a few times to mix, and label. Our IV-therapy certified CI taught me this one