reentry nurse needs help!!!!!

BarbPick · Jan 17, 2004

You do not relable IV's ever! What do you mean by renetry?

Are you licensed?

krisssy · Jan 17, 2004

Yes I am licensed. I received my RN 30 years ago. I worked as a school nurse. I never worked with IVs. I took a refresher course last spring. I am studying pharmacology on my own for now. At the beginning of March, I am taking an online pharmacology course. At the end of March I was accepted into a preceptorship program for reentry nurses(nurses coming back to nursing). Meanwhile I would really like to be able to finish this pharmacology book I am working on. What would you do in this situation? What exactly would you write on the label? thanks for any help tyou can give me. It is difficult to work without a teacher.

jemb · Jan 17, 2004

If you are not familiar with IV bags, I can understand how you would be confused.

IV bags have volume 'hatch marks' on them. Many hospitals have "time tapes" that you use to label IV bags so that you can tell if the infusion is running at the correct rate. (This practice has become less common with the use of infusion pumps, but was very helpful for gravity powered IVs.)

To visualise this, use a 500ml (2 cup) measuring cup. As each hour's volume infuses, the total volume in the bag should equal the original volume minus the hourly rate times the number of hours the infusion has been in progress. The calculation problem you have starts with 625ml. After one hour of 150cc infusing, you would have 475ml (cc) remaining. Use the measuring cup calibrations to visualize from there. Your tape would need to be placed next to, but not covering the calibrations(hatch marks).

Did this help you at all?

krisssy · Jan 17, 2004

Dear Jemb,

Thank you for your help. Looking at the measuring cup I can see what has been confusing me. The picture in my book shows an IV bag with the calibrations starting(at the top) with the number 0 and going down to the bottom of the bag with numbers getting higher. So from the top, it goes 0, 1, 2, 3, 4,5, 6, 7, 8, 9, .Each number stands for 100 more .

In the measuring cup, it is easier to see, because the numbers start at 500mL and go DOWN to 0.

In a REAL IV bag, which direction do the numbers go starting at the top of the bag?

Do most hospitals use pumps now or are there still a lot of gravity IV's around ?

thanks krisssy

jemb · Jan 18, 2004

Most of the bags that I see now are numbered with the larger # at the top, but I have seen other bags that have both ascending and descending #'s opposite each other. (Just think of it as 'amount infused' vs. 'amount remaining' in the bag.)

The 'time tape' would be the same either way. Mark the time the infusion starts at the top of the bag (full bag), and measure the hourly amount downward on the bag, marking the projected time of each hour's remaining volume on the tape.

I currently work in an outpatient chemotherapy clinic, so we use pumps for all of our infusions. Critical care units also put everything on pumps. Up until a few years ago, I worked agency in a number of facilities, and in most places, infusion pumps were used only for IVs containing medication , TPN or fluids with concentrations of more than 20 meqs KCl/liter, or a rate of 150cc/hr or greater on the floors. The usual IVs of NS, D5NS, or D5-1/2NS with no additives were generally infused by gravity.

So whether you will have pumps or gravity powering your IVs depends on the facility, the unit, the budget...

krisssy · Jan 18, 2004

Jemb

Thank you so much for your help. I am now able to do the problems. It is so much easier to understand with the numbers in descending order. I am happy to hear that today's bags come with the calibrations in descending order. This book was written in Canada 4 years ago. This website is really great. Thank you again for taking the time to help me.

I guess it takes hands on experience to get good at this.

krisssy