Jump to content

Administering NICU MEDS

Posted

Does anyone know of any books or websites that explain/describe how to administer medications in the NICU? For example, administering meds through NG tube or PIV. I'm pretty much looking for tricks of the trade, things you can only learn through experience. Any help would be greatly appreciated!

Are you a student nurse or registered nurse. Well firstly you must follow the correct guidelines and rights of giving medication. You must look at the prescription chart. Is it the correct prescription based on weight and age. Is the dose and timing/frequency correct. Is it the right medication? Does the patient have allergies or contraindications?

Is the patient nil by mouth. Then consider the route if administration and what it says.

Oral administration mainly means by mouth but can the patient have it by mouth? If the patient has a tube you must follow nasogastric tube guidelines on correctly testing the ph to check for correct placement. Can the medication be given by the ng tube.

So to recap you follow the 5 rights of medication administration

1) Is this the right patient? Check their identification, date of birth, hospital number

2) is this the right medication? Is it in date? Any allergies or contraindication?

3) What is the prescribed route of administration? Oral, nasogastric, rectal?

4) Is the dose correct. You will need to check in formulary drug book. Dont always assume it is correct

5) Is it the correct strength of medicine and is it needed now?

Finally to add there are no tricks of the trade. You must consider clinical condition of the patient. You must make sure you follow the 5 rights which I have explained earlier because if you assume you will make a mistake as you are accountable

prmenrs, RN

Specializes in NICU, Infection Control. Has 42 years experience.

If you are working, check the policy and procedures manual of the unit. They spell a lot of this stuff out for you. It should also be covered in orientation to the unit.

I am currently in the middle of my preceptorship. I am well aware of the rights of medication administration.. I guess i should've been more specific. For example I have seen an antibiotic set for 30 min, when it runs out, a flush syringe is set in place at the same rate to push the rest of the drug through the tubing. Or flushing a med through the ng tube with air or fluid.. Things like that are what I was referring to.. Thanks for the reply

cayenne06, MSN, CNM

Specializes in Reproductive & Public Health. Has 10 years experience.

Of COURSE there are tricks to the trade, OF COURSE there are things about med administration that you learn through experience, things that are not taught to you in nursing school. Seriously? I don't work in NICU so I can't comment on the OP directly, but good lord. I've only been a nurse for 3 years and I've picked up countless tips that help me be a better, safer, more time efficient RN.

I know the rights of medication administration. But I *also* know that my postpartum patient might tolerate her ibuprofen a little better if she has something to eat first, especially after a long labor. When I did pedi home health, I learned the hard way to double check the feeding port on my patient's gtube before I gave a medication, lest it squirt right back out at me when the patient coughs, because the cap was a little loose.

I'd imagine the OP wants tips about how to bundle care, how to teach parents to administer medications, how to decrease the risk of adverse effects like infiltration(positioning, comfort care, etc), things like that.

NicuGal, MSN, RN

Specializes in NICU, PICU, PACU. Has 30 years experience.

Check your med guidelines at work, they will tell you everything you need to know. And your preceptor should be going over this with you.

Units do things differently. For example, our unit flushes meds with air, the one across town uses sterile water. Always refer to protocol.

Cayenne06, that's exactly what I was referring to.. Thanks for the replies everyone

consider the guidelines in your institution first

Jory, MSN, APRN, CNM

Has 10 years experience.

I am currently in the middle of my preceptorship. I am well aware of the rights of medication administration.. I guess i should've been more specific. For example I have seen an antibiotic set for 30 min, when it runs out, a flush syringe is set in place at the same rate to push the rest of the drug through the tubing. Or flushing a med through the ng tube with air or fluid.. Things like that are what I was referring to.. Thanks for the reply

To be honest...those two tricks you learned are about 99% of it. There are no books because a five minute explanation usually does it.

Always take what the tube holds (be it IV or NG) and make sure the baby gets all the medication cleared out of the tube.

The biggest mistake I have seen nurses make is putting too much medication in a syringe and then setting the pump to give the correct amount. NEVER do this!! What happens if you set the wrong amount by accident or the device malfunctions? You can't take it back out of the baby. I always mixed what I needed and ran a line of saline behind it just enough to clear the tube. I even measured the tubing we used once and had it calculated how much was in the tube up to each port. Important for the tee tots.

NICURN29

Specializes in NICU. Has 11 years experience.

You could also check out the Neofax and the Core Curriculum for medication information.

Awesome, I will keep everything in mind.. And my nurse does show me a lot of things but I think its important to get different perspectives/resources

Awesome, I will keep everything in mind.. And my nurse does show me a lot of things but I think its important to get different perspectives/resources