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Discussion

clinical question

Everyone on here is always so helpful, I thought I'd give this a go :

1) An ABX is piggybacked to NSS going through one of the lumens on a triple lumen catheter. In my other clinicals, it always happened that for the 8 hours I was there, the pt was on a continuous maintence IV therapy (peripheral IV), so the primary was always running, and when it depleted, I hung a new bag. Now I'm in peds, and it seems different. Anyway, if the patient is NOT on maintence therapy, but the NSS is hung only so the ABX can be piggybacked on it, would you just program the NSS to run @ the prescribed rate for the ABX? And put the "volume to be infused" just a few ccs over to flush through the line and make sure the ABX goes in?Or should it be kept at KVO rate? Would this be written in the orders or is it "standard" to ru na KVO rate on something like this.

2) Same thing-basically--If an ABX is on a pinipump (infusion device) and NSS also has to be run along with the medicine through a primary IV (I am guessing to dilute it because it's hard on the veins), but this NSS is NOT a maintence fluid (ONLY there for the meds). Alright, would you only program the NSS to run for as long as the medicine is running? Is this usually done? Or should it technically be at a KVO rate?

I think I'm so confused because of my other clinical experiences where I never really had to think about these things. Please , someone help, I'm stressign because these seems so simple and yet I don't know it!:uhoh21:

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Good question. In the ER it often gets crazy enough that if I hang a minibag without a mainline bag, the line could clot off if I can't get back to the bedside in time. I usually set the NS to run at the same rate as the minibag but in a pt who is not fluid restricted, it shouldn't matter as long as the mainline isn't running wide open.

with peds you have to be sure not to fluid overload them. So I would run the abx and NSS at the rate the abx has to run in, add enough for a flush (I think its either 4cc or 25 cc? Not sure, I beleive it depends on the size of the child) and then turn it off. If its on a pump, set it to beep before it finishes totally so that you can catch it in time. so if you have to run 50mL, set it to beep at 55, so that you get the flush but it stops before you give the kid too much.

Does that make sense? I don't do peds but I think that's what I would do.

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