Ppt chapter 35

Chapter 35

Intravenous Medications

QuestionQuestion

•Is the following statement true or false?

The intravenous (IV) route of drug administration is considered the most dangerous route.

AnswerAnswer

The intravenous (IV) route of drug administration is considered the most dangerous route.

Intravenous Medication Administration

• Intravenous (IV) route: administration via peripheral and central veins is immediately effective and the most dangerous

• Situations for administering IV meds:

– Clients have disorders affecting the absorption or metabolism of drugs

– Quick response is needed during an emergency

Intravenous Medication Administration (cont’d)Intravenous Medication Administration (cont’d)

• Situations for administering IV meds (cont’d):

– Blood levels of drugs must be maintained at a consistent therapeutic level

– Client wants to avoid repeated painful intramuscular injections

– A mechanism is needed to administer drug therapy over a prolonged period, as with cancer

Administering Medications Through an Intravenous PortAdministering Medications

Through an Intravenous Port

• Continuous administration: continuous drip; adding medication to a large volume

• Intermittent administration: short-term parenteral administration of medication

– 3 types: bolus and secondary administration and volume-control set

• Intermittent administration (cont’d)

– Bolus administration: undiluted medication given quickly into a vein

o Using an IV port: extends from the IV tubing

o Using a medication lock: allows instant access to the venous system

Administering Medications Through a Lock

Medication LockMedication Lock

• Intermittent administration (cont’d)

– Secondary infusions: administration of a parenteral drug that is diluted in a small volume of IV solution

– Volume-control set: chamber in IV tubing that holds a portion of the solution from a larger container

Piggyback ArrangementPiggyback Arrangement

Volume-Control SetVolume-Control Set

QuestionQuestion•Which of the following involves the

administration of a parenteral drug that has been diluted in a small volume of IV solution?

a. Continuous administration

b. Bolus administration

c. Secondary infusion

d. Volume-control set

AnswerAnswer

c. Secondary infusion

Secondary infusion is the administration of parenteral drug that has been diluted in a small volume of IV solution. Bolus administration occurs when a substance is given all at one time. Continuous administration is the instillation of a parenteral drug over several hours. A volume-control set is a chamber that holds a portion of the solution.

Central Venous CathetersCentral Venous Catheters

• Administer parenteral medication in a large volume of blood when:

– Clients require long-term IV fluid

– IV medications are irritating to peripheral veins

– It is difficult to insert or maintain a peripherally inserted catheter

Using a Central Venous CatheterUsing a Central Venous Catheter

Central Venous Catheters (cont’d)Central Venous Catheters (cont’d)

• Percutaneous catheters: inserted through the skin in a peripheral vein

• Tunneled catheters: inserted into a central vein with part of the catheter secured in the subcutaneous tissue

• Implanted catheters: sealed beneath the skin

Tunneled CatheterTunneled Catheter

Central Venous Catheters (cont’d)Central Venous Catheters (cont’d)

• Medication administration using a CVC: continuous or intermittent infusions may be used

– Antineoplastic drugs: medications used to destroy or slow the growth of malignant cells; chemotherapy

QuestionQuestion

•Is the following statement true or false?

Antineoplastic agents are toxic only to abnormal cells.

AnswerAnswer

False.

Antineoplastic agents are toxic to normal and abnormal cells.

Nursing Implications Nursing Implications

• Antineoplastic drugs require extreme caution

• Nursing diagnosis:

– Anxiety, fear, risk for injury and infection, excess fluid volume, and ineffective protection

General Gerontologic ConsiderationsGeneral Gerontologic Considerations

• Administration of IV medications is quite common in older clients

• Percutaneous central venous line is better than risking the trauma of repeated attempts at peripheral IV sites

• Collaborate with prescribing practitioner on the possibility of administering the same drug by another route

General Gerontologic Considerations (cont’d)

• Explain the purpose and potential side effects for each drug administered, especially by the IV route

• Older clients tend to metabolize and excrete drugs at a slower rate

• Older clients tend to have more free drug in proportion to bound drug due to diminished protein components in their blood

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