Diluting IV push

[RN2B07]

I have a question..I am a new grad working with a preceptor and when I watched her draw up morphine IV 2mg she didnt dilute it, even tho the med book says to. The pt. had IV fluids running, I dont know if that makes a difference. Is she right, or should it be diluted? If it should be diluted which do you draw up first?? If a med is to be diluted, is that determined by the med book or would the hospital have a policy to go by?? Thanks:o

[twinmommy+2, ADN, BSN, MSN]

First I always run saline at 100 for a bit to dilute anything I'm giving. Then something like phenergan I dilute with 10cc syringe of saline but the other stuff like motrin I just push with the saline already running.

[UM Review RN, ASN, RN]

First I always run saline at 100 for a bit to dilute anything I'm giving. Then something like phenergan I dilute with 10cc syringe of saline but the other stuff like motrin I just push with the saline already running.

EEk! Surely you mean morphine!

[CarVsTree]

I work on a trauma floor and we give out morphine like its candy. Never dilute, but always push slowly. It comes in carpoject form anyway so to dilute we would need to draw it out of its prefilled syringe and then dilute it. We have a policy book in all our med rooms that states what is and is not diluted and how much time to push over. You should find out where yours is.

Its a great help to me as a new nurse, because I can't remember every med.

[WaynesvilleRN]

It is such a small amount. I general take multiple things into account, is there fluid running. Is the patient healthy with healthy veins, what rate is the IV going at, how much am I giving, what am I giving, etc.....2mg in a flowing IV? I would probaby just administer it slowly without a flush.....

[twinmommy+2, ADN, BSN, MSN]

EEk! Surely you mean morphine!

Oh now wouldn't that have been a tough push lol. I needed some more coffee I think:lol2:

[reddellrn]

according to an iv medication book u can dilute morphine or use undiluted. if the pt is saline locked dont forget to flush before and after administering drug. if pt has a compatable iv fluid infusing, there is usually no need to dilute morphine

[thumperRN]

I dilute most everything in 10ml of NS - it's easier to push slowly if your watching the clock. I have had multiple patient's complain about burning, and I've seen frail veins blow when meds are not diluted. It's really up to the nurse. I guess I learned to dilute everything so that's what I do. Best to check with your hospital's policy and procedures to be sure. If they have IVF running I usually won't flush before or after - only when they are SLN or the fluids aren't compatible.

[skittlebear]

Everything is not always so black and white/right or wrong. Of course, check the policies and drug info if not familiar. Some drugs have to be given diluted, some slowly over a period of time, some don't mix and others do, etc. With most things though- it's just up to the nurses judgement in a way. Patients, IV lines, drugs, and situations vary and sometimes there is no stated RIGHT way or WRONG way. You'll get more comfortable as time goes on. I know in school, things are different. Once you get out of school though, you'll become more comfortable with "real world" nursing.

Good Answer. Thank you

[maygrad07]

what if the morphine was not compatible with the IV fluids, say it was a piggy back that was running, then what would you do personally??

[RN1989]

Do it the way that the hospital policy says. If no policy on it - do it the way your instructor and/or preceptor says. After you are on your own - you learn what best practice is and incorporate it into your own practice with what you are comfortable with.

[AngelsRN]

generally if I have a piggyback that is not compatible with the regular iv fluids, I would put up a saline bag to piggy back it off of . . .then when the piggyback is done, switch it back. I always check with the pharmacy about compatibility. If it is a morphine drip that is continuous, check with your policy and doc.

[marty 08]

I appreciate this conversation regarding morphine. I have not given it yet IV, but some typical post-op orders are for 2mg Morphine increments for pain. Some nurses give 2mg undiluted but with running IV to dilute and give slowly. IF desired to dilute with NS...do many of you use the premade 10cc Normal saline syringes and add 9cc of the saline to the drawn up morphine in a 10cc needleless syringe? We are using needless ports on peripheral lines. Given slowly at the lower port near the hub and flushed pre and post, or only with the saline lock?