Specialties MICU
Published Jul 15, 2006
maolin
221 Posts
Greetings all. I'm a recently graduated, new RN on week 2 of bedside orientation. So far I'm LOVING it! I'm on an incredible team and having the time of my life. I get to do and see so many cool things everyday (cool in that "bummer for the patient" kind of way, but you know what I mean).
As a nursing student on med/surg rotations, we were instructed to dilute just about every IV med, even if the drug guides said could be given undiluted, so that we had a larger volume to push over the time required (2-5 min, etc).
Now that I'm on the unit, I'm told that even drugs that are suggested to be diluted (for example Ativan) aren't diluted. If it's compatible, just run the med in the fluid line and the fluid will dilute then. Rationale being limiting fluids going in (on all pts, not just renal or CHFers) and it's faster/easier preparation. I've gotten so used to the "student way" - it feels wierd to do it this way now - I wonder if I'm really supposed to be doing it this way. I'm not being taught a bad habit am I? Or was the student way the bad habit? And I'm finding it hard to push 0.25cc of a med for 2-5 min. Would like to get some more feedback from experienced practioners - how do you handle your IVP meds in the ICU?
millkay
62 Posts
After 4 years in ICU I still dilute some meds for IVP, especially Ativan, which is incredibly hard to manage while in a oily, pasty state. 5ml doesn't make that great of a fluid volume issue with most adult patients. I could understand if it was to be given to a neonate, but not a 70kg patient. I often find it just as easy to push meds that don't really require dilution if I use a smaller barrel syringe, so that I can gauge the time/vol ratio. My present unit charges for each pre-made NS flush, so it is economical for the patient to push the meds undiluted if possible. You're probably not wrong for diluting the meds in most cases. Think safety! congrats on the new job, career.
GooeyRN, ADN, BSN, CNA, LPN, RN
1,553 Posts
If it is a very small amount (digoxin) or something irritating (phenergan) I dilute. But things like lasix, that are quite a few cc's I do not dilute. HTH
PICC ACE
125 Posts
Your hospital's P&P and Formulary should dictate your practice. You might want to make sure your preceptors go over thes with you first!
DavidNurseEMT
23 Posts
Your facility charges for each premade NS flush. That is horrible. I go through those things like crazy.