Download Module VIII – Intravenous Therapy Procedures

RNSG 1140 – NURSING SKILLS
MODULE VIII – INTRAVENOUS THERAPY PROCEDURES
A. VENIPUNCTURE
Behavioral Objectives
Skill Content
1.
Demonstrate the correct procedure of collecting
blood by venopuncture.
2.
Describe the nursing responsibilities for
processing blood specimens after collection.
3.
Identify the proper tubes to be used for specific
laboratory tests.
1.
Collecting blood specimens by venipuncture.
Learning Opportunities
1.
Practice venipuncture on the equipment available in skills
lab.
2.
Have a peer review our technique drawing blood.
3.
View:
a. TVCC Library – Nursing Education in Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
 Basics and Venipuncture in Intravenous Therapy
Episode 1 (Inc. Medcom, 2012
b. Internet
http://phlebotomytrainingfacts.org/venipuncture/
http://yourphlebotomytrainingguide.com/2011/venipunc
ture
RNSG 1140 – NURSING SKILLS
MODULE VIII - INTRAVENOUS THERAPY PROCEUDRES
B. INITIATING AND MANAGING
Behavioral Objectives
Skill Content
1.
Discuss conditions require IV therapy.
Berman and Snyder text:
2.
Describe considerations to be included in selection
of a venipuncture site.
1.
Skill 52 - 1 Initiation Intravenous Therapy.
Checklist in syllabus.
3.
Identify common veins used for insertion.
2.
Skill 52 – 2 Monitoring the Intravenous
Infusion, Chapter 26.
4.
Identify types of cannulas used for venipuncture and
describe considerations in the selection of each.
3.
Converting a primary intravenous access to
a heparin or saline lock.
State variations in technique, site selection,
equipment and stabilization.
4.
Skill 35 - 8 Adding Medications to an IV
Solution.
Identify types of equipment and solutions used for
IV infusion.
5.
PICKAR:
a. Regulating Flow Rate Manually.
b. Infusion Pumps.
5.
6.
7.
Discuss various intravenous access devices, PICC
lines, central lines, & peripheral lines.
8.
Describe special precautions for maintaining the
integrity of IV systems with infants and children.
9.
Demonstrate the procedure for initiating and
managing IV infusions, including changing bag and
tubing, adding medication, time taping, and
calculating drip rate.
Learning Opportunities
1.
2.
View:
a. Mosby’s Nursing Video Skills
 Advanced: IV Fluid Therapy Administration
 Advanced: Management of IV Fluid Therapy
 Advanced: IV Med Administration
b. MyNursingLab: http://www.prenhall.com/mynursinglab/
Real Nursing Skills 2.0 Starting an IV; Medication
Administration by Intermittent Infusion
c. TVCC Library – Nursing Education in Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
 Pediatrics in Intravenous Therapy Episode 4 (Inc.
Medcom, 2012)
3.
4.
10. Calculate the drops per minute and milliliters per
hour of IV solutions.
5.
11. Calculate small volume IV piggybacks.
6.
12. Discuss various dosages of Heparin.
7.
13. Demonstrate the procedure for calculating dosages
of medications delivered by infusion over a
specified time period.
8.
9.
14. Discuss potential complications of IV therapy and
associated nursing interventions.
Read:
a. Applicable pages in Harkreader
b. Applicable pages in McKinney
c. Applicable pages in Lewis

Recognizing and Treating Complications in Intravenous
Therapy Episode 3 (Inc. Medcom, 2012)

Routine Care and Discontinuation in Intravenous Therapy
Episode 2 (Inc. Medcom, 2012)
Practice all procedures.
Have two peers review your technique for starting an IV. Use
checklists in syllabus.
Have a peer evaluate your ability to add medication to an IV,
convert IV to peripheral lock, monitor IV’s, regulate drip rate
and discontinue an IV.
Have an instructor evaluate your technique for starting an IV in
a group.
Have an instructor evaluate your technique for attaching a
saline lock device, adding medication to an IV, regulating drip
rate, and discontinuing an IV.
Document IV start, saline lock, and dc IV on IV Flow Sheet.
Have a peer review your understanding of Obj #’s 6, 7, 8, & 9.
RNSG 1140 – NURSING SKILLS
MODULE VIII – INTRAVENOUS THERAPY PROCEDURES
C. INTRAVENOUS PIGGY BACK (IVPB)
Behavioral Objectives
Skill Content
1.
Identify compatibility considerations in
preparing and administering IV fluids and
medication.
2.
Identify the rationale for difference in rate of
infusion for IV solutions containing
medications.
3.
State the purpose of a controlled volume
administration set.
4.
Apply the nine cardinal rules of safety in
preparing and administering IV drugs:
a. Five rights.
b. Compatibility.
c. Length of administration time.
d. Amount of medication added.
e. Dilution of solution.
5.
6.
7.
Learning Opportunities
Berman and Snyder text:
1.
Read applicable pages in Berman and Snyder.
1. Text, pages 896-899. IV medication by
intermittent infusion (through existing line and
through intermittent infusion device or peripheral
lock).
2.
View:
a. Mosby’s Nursing Video Skills
 Advanced: Intravenous Fluid Therapy
Administration
 Advanced: Management of IV Fluid Therapy
 Advanced: IV Med Administration
b. TVCC Library – Nursing Education in Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
 Pediatrics in Intravenous Therapy Episode 4 (Inc.
Medcom, 2012)
2.
SKILLS LAB:
Controlling flow using a stopcock.
3.
Volume Control Infusion, pg. 898 Figure 35 – 48.
State the advantages and disadvantages of using
intermittent infusion devices/peripheral lock.
Explain the rationale for flushing the heparin
lock with saline or with a heparin solution.
Demonstrate the procedure for administering
and managing and IVPB medication through a
peripheral lock or existing IV line.

Recognizing and Treating Complications in
Intravenous Therapy Episode 3 (Inc. Medcom,
2012)

Routine Care and Discontinuation in Intravenous
Therapy Episode 2 (Inc. Medcom, 2012)

Pain Treatment Programs for Special Populations
in Pain Management and Patient Care (Medcom
Inc., 2009)

General Recommendations for System-wide Change
(Part 1) in Preventing Medication Errors Episode 1
(Medcom Inc., 2009)

Sources of Errors and Basic Safety Practices (Part 2)
in Preventing Medication Errors Episode 2 (Medcom
Inc., 2009

Basics and Venipuncture in Intravenous Therapy
Episode 1 (Inc. Medcom, 2012)
3.
Practice your technique on administering medications by
volutrol, secondary set, and intermittent infusion device.
4.
Have a peer review your technique on administering
medications by volutrol and using a stopcock.
Behavioral Objectives
RNSG 1140 – NURSING SKILLS
Skill Content
Learning Opportunities
5.
Have two peers review your technique administering IV
medications by secondary set and intermittent infusion
device.
6.
Have an instructor evaluate your technique administering IV
medications by secondary set and intermittent infusion
device in a group.
7.
Document IVPB on MAR.
RNSG 1140 – NURSING SKILLS
MODULE VIII – INTRAVENOUS THERAPY PROCEDURES
D. INTRAVENOUS PUSH (IVP)
Behavioral Objectives
Skill Content
1.
State four purposes for administering a
medication IV Bolus.
2.
Explain why IV bolus is the most dangerous
method of drug administration.
3.
Identify how to administer IV bolus medication
through a peripheral lock and existing IV line.
4.
Identify potential complications for clients
receiving IV bolus medications.
5.
Identify actions to correct complications for
clients receiving IV bolus medications.
6.
State the result of too rapid infusion of an IV
push medication.
7.
State key nursing considerations for IV
administration of the following medications
including:
a. Generic and trade names.
b. Classification.
c. Action.
d. Indications and dosage.
e. Adverse effects; contraindications.
f. Interactions with lab and drugs.
g. Nursing interventions and considerations.
h. Patient teaching needs.
1) digoxin (Lanoxin).
2) furosemide (Lasix).
3) meperidine (Demerol).
4) metachlorapromide (Reglan).
5) methylprednisolone (SoluMedrol).
6) morphine sulfate (Morphine).
7) phenytoin (Dilantin).
Learning Opportunities
Berman and Snyder:
1.
1.
Skill 35 - 9 Administration of Intravenous
Medications as a Bolus Dose
Note: When preparing medication for IVP, you
will dilute unless contraindicated.
(Checklist in syllabus.)
2.
2.
Using an Intermittent Device, page 899
3.
Patient Controlled Analgesia, pgs. 1029-1030
Read applicable pages in Berman and Snyder
View:
a. Mosby’s Nursing Video Skills
 Advanced: Intravenous Medication
Administration
b. MyNursingLab:
http://www.prenhall.com/mynursinglab/ Real Nursing Skills
2.0 Starting an IV; Medication Administration by
Intermittent Infusion
c. TVCC Library – Nursing Education in Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
 Pediatrics in Intravenous Therapy Episode 4 (Inc.
Medcom, 2012)

Recognizing and Treating Complications in
Intravenous Therapy Episode 3 (Inc. Medcom,
2012)

Routine Care and Discontinuation in Intravenous
Therapy Episode 2 (Inc. Medcom, 2012)

Pain Treatment Programs for Special Populations
in Pain Management and Patient Care (Medcom
Inc., 2009)

General Recommendations for System-wide Change
(Part 1) in Preventing Medication Errors Episode 1
(Medcom Inc., 2009)

Sources of Errors and Basic Safety Practices (Part 2)
in Preventing Medication Errors Episode 2 (Medcom
Inc., 2009

Basics and Venipuncture in Intravenous Therapy
Episode 1 (Inc. Medcom, 2012)
3.
Practice administering IV bolus medications via
intermittent infusion device and IV infusion line.
4.
Review the medications listed in Objective 7 in your drug
book.
Behavioral Objectives
RNSG 1140 – NURSING SKILLS
Skill Content
Learning Opportunities
5.
A drug book with IV considerations is required for checkoff and in clinical.
6.
Have two peers review your ability to administer IV
medication via intermittent infusion device and IV
infusion line.
7.
Have an instructor evaluate your ability to administer IV
medication via intermittent infusion device and/or IV
infusion line in a group.
8.
Be prepared to answer specific questions listed on sample
IV push order page in syllabus.
9.
Document procedure in nurses’ narrative notes and MAR.
Turn in for evaluation.
RNSG 1140 – NURSING SKILLS
MODULE VIII - INTRAVENOUS THERAPY PROCEDURES
E. BLOOD ADMINISTRATION
Behavioral Objectives
Skill Content
Berman and Snyder
Learning Opportunities
1.
List risks associated with blood transfusions.
2.
Describe safety precautions in checking blood
products prior to administration.
1.
Skill 52 – 6 Transfusion of Blood
Components. Checklist in syllabus.
3.
Identify compatibility considerations in
administering blood products.
2.
Review blood transfusion flow sheet.
4.
State the protocol necessary to obtain blood
products in the hospital setting.
5.
State the baseline data to be obtained prior to
transfusion.
1. Read:
a. Applicable pages in Berman and Snyder.
b. Applicable pages in Lewis, pages 706 - 707.
2. View:
a. MyNursingLab: http://www.prenhall.com/mynursinglab/
Real Nursing Skills 2.0 , Administering IV therapy;
Initiating Blood Therapy
b. TVCC Library – Nursing Education in Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
Informed Consent: Basic Principles for Staff Education
(Medcom Inc., 2004)
3. Practice inspection of blood products and administration of
blood products using the Y-set.
6.
State signs and symptoms that can indicate
adverse reactions to blood.
4. Have two peers review your technique in administering blood
using checklist in syllabus.
7.
Identify nursing actions to be done if an adverse
transfusion reaction is suspected.
5. Have an instructor evaluate your techniques in blood
administration in a group.
8.
Explain the indication for use of pressure
sleeves and blood warming devices in
administering blood products.
6. Answer blood transfusion questions provided in syllabus.
7.
Document procedure in nurses’ narrative notes and turn in
for evaluation.
8. Complete blood transfusion flow sheet and turn in for
evaluation.
RNSG 1140 – NURSING SKILLS
MODULE VIII – INTRAVENOUS THERAPY PROCEDURES
F. CENTRAL VENOUS LINES
Behavioral Objectives
Skill Content
1. State the uses for central venous catheters.
Berman and Snyder:
2. Define Total Parenteral Nutrition (TPN) and
hyperosmolarity.
1.
Changing the Dressing for a Central Line
Catheter, pages 1496 - 1498.
3. Describe clinical situations in which
hyperalimentation may be indicated.
2.
Changing the IV solution and Tubing for Central
Venous Catheter.
4. Identify potential complications for patients
with subclavian or jugular lines.
3.
Flush unused ports.
Read:
Applicable pages in Berman and Snyder.
Applicable pages in McKinney, pages 982-983.
Applicable pages in Lewis, pages 328-330.
2.
View:
a. Mosby’s Nursing Video Skills

Advanced: Vascular Access
b
c. TVCC Library – Nursing Education in Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
 National Patient Safety Goals 2012 (Medcom Inc.,
2011)

Never Events and Hospital-Acquired Infections: Prevention
Practices in Never Events and Hospital-Acquired Infections
(Medcom Inc., 2009)
3.
Practice changing a central line catheter dressing and
changing the IV solution with new tubing and flush
unused ports.
4.
Have two peers review your technique in changing a central
line catheter dressing and changing the IV solution, tubing,
and flush unused ports, using checklist in syllabus.
5.
Have an instructor evaluate your technique in changing a
central line catheter dressing, changing the IV solution,
tubing, and flush unused ports.
6.
Document changing solution, tubing and dressing changes
on IV flow sheet.
Checklist in syllabus.
5. Identify complications for patients receiving
TPN or hyperalimentation and nursing actions
to prevent these complications.
6. Describe the purpose and complications of
flushing unused ports in a multi-lumen
catheter.
7. Demonstrate care of a central line catheter
including changing solution, tubing and
dressing changes.
N/ADN Syllabus/Transition/Module VIII
Learning Opportunities
1.
Revised 04/13