IV push administration

[Gottago]

You go into a pt's room to administer 2mg/1ml of morphine via IV push. The pt is receiving NS at 100 ml/hr. Question: Do you need to flush the IV line before & after administering the morphine with NS? Or, since the pt is receiving NS at 100 ml/hr, no flush necessary.

[maolin]

It is absolutely necessary, no, but it certainly wouldn't hurt either. As a student, it's better to get into the habit of always flushing before & after IVP meds. If there was an abx or electrolyte piggybacked into the NS, it's safer to flush around the morphine dose.

[moongirl]

we were taught- as students, yes it is necessary. When you are a grownup nurse, no.

[Sunshine Sweetheart]

We are being taught that you do not have to flush. Just pinch off the tubing above the port and push some medicine and then unpinch the tubing to let fluid run through and so on until the medicine is done. You would of course flush before and after if the patient is heplocked and doe not have fluid running.

[dawn1971]

We were taught no flush in that situation.

[Daytonite, BSN, RN]

Now, think about and rationalize this out. You are taught that every medication has a certain safe rate that you may push it into the vein. The only way you can control that rate of infusion is when you push it into the vein yourself and are controlling the "push", both the medication and the flush solution. Whether it's morphine or some other drug that is also compatible with saline, shooting it into the IV line and letting the IV fluid flush it into the vein is not responsible. How are you controlling the rate of injection that way? What if the IV is running at 50cc/ hr? Or, 200cc/hr? Mark my words. . .this may come up on a NCLEX question, so you need to know the rationale behind this. As good practice, you should flush the line before and after the medication, no matter what it is, to insure, for the patient's safety, that it is being given properly.

And, by the way, this idea that there is a different way, better way or secret shortcuts to do procedures that magically is at your disposal when you are finished with school is a bunch of hogwash. There are right ways, wrong ways and sloppy ways. If there were acceptable shortcuts, your instructors would be showing them to you. Make a decision right now as to how you are going to practice as a real nurse. It's sometimes hard to keep your integrity and follow the good techniques we were taught in nursing school while others around us are making up their own shortcuts and little deviations from the rules to get done quicker. Who's the winner? Not the patient. We're supposed to be advocates for the patients. I'm for quality and the most excellent patient care I can give, how about you?

[slinkeecat]

I agree w/ daytonite!!!!!

Well said!!!!!!!

[hrtprncss]

PRN med I would, if you push the 1cc mso4 and leave it as is then it will take time for the IV solution to push it in, and your patient would be in pain for awhile. I guess I'm being anal.

[gtmoore]

didn't realize students are "allowed" to administer IVP meds. But, no, no reason to flush before, but you should flush after, obviously. As a general rule, you should also dilute the morphine in a 10 cc NSS flush

[firstyearstudent]

didn't realize students are "allowed" to administer IVP meds.

How else would they learn?

[Curious1alwys, BSN, RN]

I know we are taught to flush at the SAME RATE as the push, so that would mean, NO you can't just let the IV fluid run in, like Daytonite said.

I did not know you HAD to dilute morphine. I only know that many people do because they find it difficult to push such a small amt over a long period of time.????

[Nili927]

How else would they learn?

In myschool we're not allowed to give IVP meds either.

It's a safety issue for the patient as well as the student.