Do you look up the push rate for IVP meds?

Nurses General Nursing

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In school, we're taught to ALWAYS look up the push rate of an IVP and always go by that. But in clinicals, I've had people tell me they really don't do that unless they're serious meds (pain meds, digoxin, etc) and even then, they don't go at a certain rate.. they just go very slow. What is the general rule of thumb??

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

Unless I'm familiar with the medication's push rate, I always look it up. Remember that IV medication mistakes can be much worse than with an oral or injectible administration. This is because after giving medication IV push, it is directly in the bloodstream. Therefore there isn't much time to counteract an oops. When I was in Oncology we gave some chemotherapy by IV push by hand, something like 30mL over 15 minutes if I remember correctly.

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With the exception of adenosine, I push everything slowly, even narcan. people in the ER slam it and then you get someone bolting straight up like in pulp fiction, or worse, vomiting all over the place. I had another nurse try to tell me to push it fast, and I said where's the policy. she never came back with the policy. I knew the policy cause as part of our orientation we had to do the e-learnings and in fact per policy we are supposed to even dilute the narcan, which no one ever does.

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Specializes in CCU, SICU, CVICU.

Only med you should ever slam in is Adenosine. That being said, with a very agitated or restless intubated patient, I've had to push the Midaz fairly fast.

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Specializes in acutecarefloatpool. BSN/RN/CMSRN. i dabble in pedi.

I do.

I pushed IV vitamin B once. I couldn't find a push rate in my drug book so I pushed it over 5 seconds or so. I thought "Oh it's just vitamin B, it probably doesn't even matter."

Wrong. The patient yelled bloody murder because it burned so bad going in. I immediately unclamped her IVF and it subsided. So yeah, I look it up and if I can't find it I call pharmacy. xD

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Specializes in ER.

If you have a ml of medication, and you are pushing in the Y site, you can put it right in, but know that the med will be entering the body based on the rate per hour of the IV. So its pushed quickly into the TUBING, and then infused slowly because the IV rate is slow.

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Specializes in MCH,NICU,NNsy,Educ,Village Nursing.

Yes. Always, unless I know it like the back of my hand. Standards of practice are to be followed, and following them will help you protect your license, no matter what others tell you.

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