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

[beachbum3]

Not that this counts for real world, but in school they had us clamp the IVF, then push, then unclamp. They also never had us dilute anything, unless it was ordered to be diluted. So I'm thinking its ok not to dilute the morphine, as long as it is pushed slowly.

[Virgo_RN, BSN, RN]

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?

If I need to dilute MS, I squirt out some of the NS (if the MS is 2mg/mL, for example, I'll squirt 1mL out of the NS), then draw up the MS into the remaining NS. Our MS comes in the carpuject syringes. Some nurses have their own carpujects, but I just draw it up out of the carpuject syringe into the premade NS syringe.

[Virgo_RN, BSN, RN]

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

My med book says MS may be given undiluted.

[RN511]

I am a senior nursing student. We just had a stimulation lab where we had to give morphine iv push (2mg/1ml). Our med book says that you don't have to dilute but because you are suppose to push this medication over 5 minutes, it is a lot easier to dilute it in 10 ml of NS and push 2 mls every minute for 5 minutes. We flush with normal saline before and after given this med. When you flush afterwards, make sure you also flush slowly or it defeats the purpose of pushing in the med slowly.

I am not sure about what is done differently if IV fluid is running. I am pretty sure that we have to stop the IVF or put it on pause while we give the push. I don't think you would want to use the IVF to flush afterwards because it may flush to quick? I will have to double check with my teacher.

[BabyLady, BSN, RN]

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

I always mix every drug according to the drug book/vial instructions...IV running or not.

[OttawaRPN]

Every facility should have a parenteral drug guide available for staff which lists everything you possibly need to know about administration, compatibility, contraindications etc. If your facility doesn't have one, get on your NM stat!

[Altra, BSN, RN]

I am a senior nursing student. We just had a stimulation lab where we had to give morphine iv push (2mg/1ml). Our med book says that you don't have to dilute but because you are suppose to push this medication over 5 minutes, it is a lot easier to dilute it in 10 ml of NS and push 2 mls every minute for 5 minutes. We flush with normal saline before and after given this med. When you flush afterwards, make sure you also flush slowly or it defeats the purpose of pushing in the med slowly.

I'm sure your simulation lab was stimulating ... (j/k)

One thing to think about with the flushing slowly concept -- if you are administering meds through a peripheral IV, the catheter in the vein is less than 2 inches long. By the time you have pushed 10mL of your med diluted in saline, it is already well into the patient's circulation. Push the med appropriately according to drug guides, your facility's policies, and your good nursing judgement -- don't sweat the flush.