Adding Medication to Intravaneous Fluid Containers

Check drug order against MAR.

  1. Check for drug compatibility, if needed.
  2. Assess patient for fluid imbalance, drug allergies, infiltration, and phlebitis.
  3. Prepare prescribed medication, and verify patient's identity.
  4. Perform hand hygiene.
To add medication to new container:
  1. Locate injection port on plastic IV solution bag or injection site on IV solution bottle.
  2. Wipe port or injection site with alcohol or antiseptic swab.
  3. Remove needle cap or sheath from syringe and insert needle or needleless adapter of syringe through center of injection port or site. Inject medication; then withdraw syringe.
  4. Mix medication and IV solution by turning bag or bottle gently end to end.
  5. Complete medication label with name and dose of medication, date, time, and nurse's initials. Stick label on bottle or bag. If required, also apply a flow strip.
  6. Spike bag or bottle with IV tubing, prime IV tubing if necessary, and hang. Regulate infusion at ordered rate.
To add medication to existing container:
  1. Prepare vented IV bottle or plastic bag:
  2. Check volume of solution in bottle or bag. Close IV infusion clamp.
  3. Wipe medication port with an alcohol or antiseptic swab.
  4. Insert syringe needle through injection port, and inject medication.
  5. Lower bag or bottle from IV pole and gently mix. Rehang bag.
  6. Complete medication label and stick it on bag or bottle.
  7. Regulate infusion to desired rate.
  8. Properly dispose of equipment and supplies. Perform hand hygiene.
  9. Observe patient for drug reaction, infiltration, phlebitis, and fluid volume excess