IV saline/hep lock

Yes, you should assess whether or not the INT is patent.


flush INT, med, flush INT

your correct.... usually checking the patency of the line is part of your med administration record, it would read something like NS flush 0700 q 12 hours... or something like that... when you administer a med you make sure it's patent by flushing a little, then give the med at the appropriate rate, then flush the medication in at the appropriate rate also. check your unit policy on the clamping or not...
The line should always be primed if it's attached. if you have any doubt, you can aspirate into a syringe, either empty and discard and re flush or push back in and flush again.
Hope that makes sense, it's a good sign that your asking questions and not just taking a 'brush off' to your questions!!

We have a standard on our floor to flush saline locks at twice a day. its not an order, heck, i don't know if its a policy or not, but its what is expected.

Actually this is not always true - many times you can not aspirate. Most peripheral lines should not be drawn from after the first insertion, almost all the rest should not be drawn from after 24 hours. (Of course there will be times you will break this rule, but for most times it stands).

The line is primed when the IV is first inserted (either right away or after a blood draw) and should always be primed. At times it may not be due to someone not clamping the line. In that case you can try to aspirate to pull the air back but if it doesn't work you might need to push the air in. That little air will do nothing other than cause a little pain to the person (sometimes they won't even feel it).

You should always flush first, give the med, then pulsatile flush (kind of a jerky flushing) and clamp the line as you flush - this help insure it is clear throughout.

I always try to assess the line by flushing during assessment, although in many facilities it can be a part of the med order - flush peripheral iv q8hrs and prn. Also watch those on strict fluid precautions (very rare - except for NICU) because even a little bit in a flush (10mls) adds up fast if you are doing it every assessment and every med and every 8 hrs.

Hope this helps.

Pat

Your initial assessment for each pt with a line needs to include its patency. That fact that your preceptor is not assessing the line at the beginning of his or her shift is negligent.
Also remember, some meds are incompatible with normal saline (Neupogen and Amphotericin B to name two) so you could not do Saline flush, Drug, then Saline again, but rather, Saline, D5W flush, Drug, D5W flush, and then finish with Saline.