IV questions

talaxandra · Sep 14, 2004

Hi daz - I would put a) for question four: drugs that need to be well diluted also need to be administered over a period of time. You're on the right track to think of renal function, but in that case it's the dose that's altered, not the rate. I would be reluctant to push meds with a neonate, but that's in no small part because NICU scared the hell out of me! Hope this helps!

frann · Sep 14, 2004

I'm a student nurse and trying to complete this IV assignemnt with multiple choice questions and i'm stuck on a few and was wondering if i could get your guy's opinions on what u think the best answer is? I've included what i think the correct answer is too.. i'm soryr, i'm sure these questions are like super easy to some of u lol
1) Adverse effects to IV medications
a) should always be counterated by an antidote
b) generally occur at the time as the therapeutic effect
c) are always preventable
d) can not be preventable
(I would say - b )
2) Factors in determining rate of administration are:
a) purpose for which drug is prescribed; adverse effects releated to rate of administration
b) availability of antidote; metabolic rate
c) timing of therapeutic effect; dosage
d) half life of drug; distribution
(I would say - a)
3) IV push meds are indicated
a) in an emergency when slow administration of drug is necessary
b) to obtain peak drug levels in the blood stream
c) when delivering a drug that can be diluted
d) all of the above
(I would say d)
4) IV push meds are contraindicated
a) when the drug must be diluted in a large colume prior to administration
b) when there is a reduction in renal function
c) when delivering very small doses to neonates
d) in an emergency when rapiud administration of the drug is necessary
(i would say b)
True or False: When administering narcan IV push, the port furthest away from the patient is used
( I would say false)

here's my 2 cents

#1 I would say a-if a patient has an adverse effect to an iv med. wouldn't you want to give an antidote.?

#3 b-a and c don't make sense. In a emergency sit. you don't give iv push meds slowly

# 4 a-iv push med is not a large volumne

#5 false

CCU NRS · Sep 14, 2004

1 = B

2 = A

3 = B

4 = A

5 = F

the reanl question is a trick, all of the above is often our fav but be careful.

1 most adverse reactions with IV push will be almost instant, but that is also the therappuetic time because it is going directly into the blood stream for this purpose.

2 all drugs that can be given IV push will have a reommended rate of push ie give slowly over 2 minutes, or push 1 Mg per minute etc or infuse rapidly in under one minute.

3as someone else noted you do not want slow reaction in an emergency so the quickest route to the blood stream is the best answer.

4 some meds must be diluted in large amount of solution 50-100cc which makes giving them push improbable however once mixed they may be ordered to be given over 5 min so you may be setting a pump at 1000cc/hr to deliver 50cc over 5 min

5 this one is backwards you want the port closest to the patient's heart, it must be a patent site tho or your Narcan will not get into the blood stream which will do zero good

talaxandra · Sep 15, 2004

#1 I would say a-if a patient has an adverse effect to an iv med. wouldn't you want to give an antidote?

There problem with response a) is that antidotes are given for drugs, not for adverse reactions (ie antivenom is the antidote for snake venom, not for the effects of the venom).

If, for example, a patient develops an anaphylactoid reaction to penicillin you would administer Phenergan, adrenaline, steroids... medications that inhibit the inflammatory response.

Additionally, some adverse reactions don't have medications to reverse their effects - Red Man Syndrome, associated with too-rapid infusion of Vancomycin, is one of these.

Tweety, BSN, RN · Sep 15, 2004

Lots of meds have the potential to be renal toxic, so the benefits have to outweight the risks. I agree that you can't IV push meds that must be diluted in large volumes, you hang them and piggy back or primary them at a specific drip rate, not IV push. For instance Vancomycin is typically mixed in 300 cc bags, you wouldn't stand there and IV push that.

Thanks for making me think.

CCU NRS · Sep 15, 2004

I'm a student nurse and trying to complete this IV assignemnt with multiple choice questions and i'm stuck on a few and was wondering if i could get your guy's opinions on what u think the best answer is? I've included what i think the correct answer is too.. i'm soryr, i'm sure these questions are like super easy to some of u lol
1) Adverse effects to IV medications
a) should always be counterated by an antidote
b) generally occur at the time as the therapeutic effect
c) are always preventable
d) can not be preventable
(I would say - b )
2) Factors in determining rate of administration are:
a) purpose for which drug is prescribed; adverse effects releated to rate of administration
b) availability of antidote; metabolic rate
c) timing of therapeutic effect; dosage
d) half life of drug; distribution
(I would say - a)
3) IV push meds are indicated
a) in an emergency when slow administration of drug is necessary
b) to obtain peak drug levels in the blood stream
c) when delivering a drug that can be diluted
d) all of the above
(I would say d)
4) IV push meds are contraindicated
a) when the drug must be diluted in a large colume prior to administration
b) when there is a reduction in renal function
c) when delivering very small doses to neonates
d) in an emergency when rapiud administration of the drug is necessary
(i would say b)
True or False: When administering narcan IV push, the port furthest away from the patient is used
( I would say false)

I will just add a little safety note here for everyone's benefit

Never give Potassium IV push this would seem to be a no brainer but I have actually seen residents write this order. Students: What would happen if Potassium were given IV push undiluted?

asapstat · Sep 15, 2004

Side effects are those that might occur...adverse reactions are the unexpected, therefore may not be preventable.

"IV Bolus" meds are given as quickly as possible, IV push meds are given over a prescribed period of time & lesser volume of fluid ie. 50 cc or less

The idea behind narcan is get it into the patient so the port closest to the patient is the one I'd choose.

IV push meds are given so that you can reach therapeutic blood levels quickly.

CCU NRS · Sep 15, 2004

Side effects are those that might occur...adverse reactions are the unexpected, therefore may not be preventable.
"IV Bolus" meds are given as quickly as possible, IV push meds are given over a prescribed period of time & lesser volume of fluid ie. 50 cc or less
The idea behind narcan is get it into the patient so the port closest to the patient is the one I'd choose.
IV push meds are given so that you can reach therapeutic blood levels quickly.

hey asap stat I was wondering if you can give the origin of the word stat? Also I have added a couple of letters to asap at my work I have only actually enlightened a couple of my co-workers to it but I occassionally use ASAMFP I am sure you get it.

HillaryC, RN, CRNA · Sep 16, 2004

I took latin for 7 years, and as I recall, stat was the latin word for immediately.

Hillary

hey asap stat I was wondering if you can give the origin of the word stat? Also I have added a couple of letters to asap at my work I have only actually enlightened a couple of my co-workers to it but I occassionally use ASAMFP I am sure you get it.

CCU NRS · Sep 16, 2004

i took latin for 7 years, and as i recall, stat was the latin word for immediately.
hillary

i was actually trying to bait asap, i am sure you have heard

shake that orifice toots

HillaryC, RN, CRNA · Sep 16, 2004

sorry, i'm oblivious. i shouldn't have answered :) i have no idea why you're trying to bait asap.

take care,

hillary

i was actually trying to bait asap, i am sure you have heard
shake that orifice toots