IV Pump question

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When you are using an IV pump and pressing the buttons to set it up,

let's say the

Doctor's Order: 500 ml NS with 20 mEq KCl q6h

and you type in that the rate is 83 ml/hr

What do you put in as the volume to be infused? 500 or 475?

This website says to type in 25-50ml LESS than what you have because if you type in 500, air will be put in the person's veins and you want to know before the bag actually runs out...I dont know in real life situations if you do that because in clinicals, I never had an IV pump.

http://classes.kumc.edu/general/IVPump/IVSimulation.html

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Our instructor has always told us to put in at least 50 less than is in the bag so that it beeps before it runs air into the patient. Good luck!

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Specializes in Pediatrics Only.

I've always set the IV pump to less then whats in the bag. If I were to hang a bag of 100ml NS, I would set the VTBI (volume to be infused) at about 985 or so. Now if you prime it manually and loose a lot of fluids, I'd set it at 950.

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Specializes in med/surg, telemetry, IV therapy, mgmt.
This website says to type in 25-50ml LESS than what you have because if you type in 500, air will be put in the person's veins and you want to know before the bag actually runs out...I dont know in real life situations if you do that because in clinicals, I never had an IV pump.

http://classes.kumc.edu/general/IVPump/IVSimulation.html

In actuality, each IV bag contains approximately 50 to 75cc of overfill. So, even if you have a 500cc bag of fluid and you program 500cc to be infused into the IV pump, you are going to be OK. That is just what the instructors at that nursing school are teaching their nursing students. In order to get the correct answers to the scenarios at that site you will have to program the pump their way. However. . .it's not the way it's done in actual practice by some nurses, including me.

For all practical purposes, the last thing you want to happen is for your IV bag to run "dry". Believe me, it's a pain in the orifice to have to get the air out of the IV line and the drip chamber without having to change the tubing. So, it's far better to avoid that from happening by just programming less than 500cc to be infused into the pump. That way, the pump alarms. You go into the room and see that you are going to need a new bag of fluid. You reset the pump to deliver another 50cc while you retrieve the next bag of fluid to hang. Just in case you get sidetracked and didn't get the next bag of IV fluid (call lights, phone calls from docs, who knows what else!), the pump is going to alarm again after it pumps the 50cc to be infused into the patient. Your IV bag still won't be "dry" and you have another chance to get the next IV bag hung. This is an old nursing trick. One which you will probably get hip to and do yourself when you become a busy staff RN as well. We nurses learn these little short cuts when we work with this equipment day in and day out and are very busy.

Be assured that the IV pump will detect air in the IV line and will alarm and stop pumping before any air ever reaches the patient's vein. The air detectors are located where the tubing is seated in the pump mechanism. They detect the very tiniest of air bubbles, which you will find as a staff nurse, is yet another headache you will need to learn to deal with, especially when the bubble is so small you can't see it, but the pump can!

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Specializes in Psych, Med/Surg, LTC.

We usually program it for 50cc less than what is to be given/bag changed. That way it is like a reminder for us that we have to run to get a new bag when we get a chance. (We aren't suppossed to leave the bags in the rooms) This way if a co-workers pump alarms we can reset it for 25 cc's and let them know that their pt will soon need a new bag.

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Specializes in Gerontological, cardiac, med-surg, peds.

With pediatric and elderly clients, I always instruct my students to program 2 hours' worth of infusion, no more. (In other words, no more than double the infusion rate for volume. If the infusion rate is 75 ml/hr, then the volume should be set at 150 ml.) This is a fail-safe mechanism to help protect the client from fluid overload, if the pump were to malfunction. Besides, one needs to be checking on the patient and the IV site/ infusion AT LEAST every hour, and a beeping pump is a reminder that a check is past-due.

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Specializes in med surg, tele, ortho, preop, recovery.

Does anyone have the answer to the 3rd problem for this site? I cant get it right.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

I've tried a number of different solutions and even checked the information in the PDR on cefazolin. Either the software is not working or there is something querky programmed into the thing. 2 grams of cefazolin (Ancef) is usually mixed in 50 or 100cc of fluid, just about any IV fluid, and infused over 30 to 60 minutes. I even tried accounting for diluent mixing the powdered cefazolin although the problem never mentioned that and the pump still said the infusion was wrong. I don't think there are any answers posted for those cases.

Take solice in the fact that you can at least play around with this virtual pump. I promise you that the real ones won't do this with you!

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