Confused with IV

[enfermeratobe]

Hello everyone third semester nursing student here. I was an Lpn first and then transferred into this program second semester. In Lpn school we never went over iv how to use them set them up nothing like that. Students learned how to use them first semester a large overview. I had to learn as I go and never got a formal lecture.My clinical instructor wants us to know them perfectly or we can possibly get a clinical fail. And my instructor intimidates me so asking for help usually backfires on me. Yes I have practiced in the lab , yes I have looked up some material on it but not having a formal long lecture on the overview of it kills me. Does anyone know any good YouTube videos reading material anything to help? I passed my competencies and understand the fluids what there used for , how to prime and set up, piggy back infusions , rates and what not but I feel confused when seeing orders and knowing how to set up the iv if primary are running what tubing to use secondary or y ports. Thank you for your help just want clarification!

[NurseGirl525, ASN, RN]

Have you never worked as an LPN? What kind of pump is being used? Alaris? What is it exactly you need to know? If it beeps hit silence!!!! Very first rule. Then, troubleshoot.

[enfermeratobe]

I geuss my biggest things is sometimes I get confused on how set ups should go like if I have a primary running and I need to know whether to give something piggy back or disconnect it completely and give in two different lines or I was looking up things about y ports as well.i understand we always check for comparability with the med and whatever is running and we flush and assess iv lines before administering the meds but how do we know whether something I so Inc on as a piggy back or I need complete new line.

[Horseshoe, BSN, RN]

If you go to YouTube and put "How to hang an IV piggyback" or "IV therapy" into the search window, you'll get lots of hits.

[AceOfHearts<3]

A lot of times deciding on if it can be piggybacked, y-sited in, or has to run in a separate site depends on facility policy.

At my facility heparin is ALWAYS ALWAYS run as a primary- it absolutely cannot be piggybacked. In fact, most of our drips- lasix, cardizem, etc. have to be primary. I had only 1 site available with a patient on a heparin and cardizem gtt (could be mixing drugs up) so I had two different pumps so each could be the primary and the cardizem was hooked up to the y-site. My manager really prefers that heparin go in one site and cardizem in a second though- that way if there are any issues at the site we know exactly what drug caused it.

I almost always piggyback IV abx, electrolytes (mag, K+, etc.), and Venofer. I hook a 250 cc flush bag up and set it to run as soon as the piggyback is finished or I might run the piggyback concurrently with IVF. Hooking the 250cc flush bag as the primary ensures I can hook up multiple piggybacks to the primary tubing throughout the day. For instance, I'll run the Zosyn IVPB, flush the primary line with the flush bag, run Vanco IVPB, then flush the primary line with the flush bag, then run Levaquin as IVPB (or potassium, mag, etc.). By using the primary line as the flush bag I only need to potentially replace the secondary line with each new piggyback (if they aren't all compatible) which saves me time (and saves money). I run concurrently especially if the IV piggyback is going to take a long time- my facility runs Zosyn over 4 hours, so I'm nit stopping IVF for 4 hours (I instead run them together).