New Grad ??? IVP meds

[Bec717]

Hi all and thanks for the info in advance.

For IVP, do you prefer to dilute the N/S to admin or do you flush, push meds, flush?

Are they any meds you would not be able to dilute with N/S to admin?

And my coach told me if I need to give Ativan,IVP, I should admin fast (less than 30 seconds) and with sterile water.

I thought you never pushed an IVP med fast unless it's during a code for ACLS?

Thanks!

[fiveofpeep]

Although the info is very valuable here, I have a suggestion:

ask the pharmacist whenever you are confused about the administration of a med and cannot understand from what the drug guide says.

many meds are different so you cant get a blanket answer that would apply for all.

during work you should look up the rate for the IVP med on your drug guide under "administration" and it should tell you. But if you have any questions, the pharmd would be the next best bet :)

[RedCell]

Hi all and thanks for the info in advance.

For IVP, do you prefer to dilute the N/S to admin or do you flush, push meds, flush?

Are they any meds you would not be able to dilute with N/S to admin?

Try diluting some diazepam in a saline solution. You get a pretty cool yet easily explainable RXN.

[Bec717]

Crystals will form~

[Bec717]

So no N/S with sodium bicarb, diazepam~

[brownbook]

First of all I forget way more than I remember about most IVP drugs!!!!! IVP drugs you give a lot, once or twice a day, you remember. Drugs you give once in a while are hard to remember and you can easily get mixed up. I am 99% sure Ativan is given SLOWLY over 2 minutes!!!!! But that is not the point. Don't trust, don't assume, co-workers, me, or even your "coach" are correct!! Unless you are in a REALLY STAT situation you look it up. Find a small basic easy to use IV medication book. Flag the pages of drugs you use. Carry note cards with you of the basic drugs you use frequently. NO ONE CAN MEMORIZE EVERY DRUG RATE AND DILUTION!!!

[RedCell]

Crystals will form~

Yes, that is correct. Why does this happen though? Look it up and you will be able to easily determine various other medications that can and cannot be diluted and/or mixed.

[PostOpPrincess, BSN, RN]

Go with the drug book.

[imaRN08]

don't ever just go with what someone else says, even if they have been a nurse for years. when in doubt look it up in the drug book, or call pharmacy.... didn't you learn this in school??

[Tait, MSN, RN]

don't ever just go with what someone else says, even if they have been a nurse for years. when in doubt look it up in the drug book, or call pharmacy.... didn't you learn this in school??

I am sure she "learned" a lot in school. I do not think she is wondering when to call the pharmacist, but is looking for general techniques of other RN's.

I personally dilute all of my IVP meds unless contraindicated. Most IVP's cause some damage to the veins, therefore I dilute them to make them as gentle as possible and push slow. You can always push slow, except for as you stated, in a code/crisis situation.

I would never "slam" Ativan, what would be the benefit? Remember, once you put it in you can't take it back.

Tait

[highlandlass1592, BSN, RN]

If you don't want to use a drug book, there are many iPhone apps as well as PDA apps you can easily download then carry in your pocket to look up such topics. I'd highly recommend them. Like another poster stated, I usually dilute all the meds I push...also makes it easier to give a partial dose, IMHO. And I use my drug references a lot.

[meandragonbrett]

And my coach told me if I need to give Ativan,IVP, I should admin fast (less than 30 seconds) and with sterile water.

You can dilute lorazepam with NS. Go with your gut.....what is your coach's rationale on giving lorazepam fast? It makes no sense.