Intravenous Bolus Medication Administration

 
Review drug order, and check for drug compatibilitywith IV solution. Assess patient for drug allergies, infiltration, and phlebitis.
  • Check medication label against MAR. Prepare medication from vial or ampule.
  • Perform hand hygiene, verify patient's identity, and put on disposable gloves.

Intravenous push (existing line):

  1. Select injection port of IV tubing closest to patient. Clean injection port with antiseptic swab. Allow to dry.
  2. Connect syringe to IV line: Insert needleless blunt cannula tip of syringe or a small-gauge needle containing drug through center of port.
  3. Pinch tubing just above injection port to occlude IV line. Pull back gently on syringe's plunger to aspirate for blood return.
  4. Release tubing, and inject medication over time required by institutional policy, pharmacist, or medication manual.
  5. After injecting medication, withdraw syringe, and recheck fluid infusion rate.

Intravenous push (IV lock):

  1. Prepare flush solutions according to institutional policy.
  2. Saline flush (preferred) method: Fill two syringes with 2 to 3 ml of normal saline solution.
  3. Heparin flush (traditional) method: Fill one syringe with ordered amount of heparin flush solution. Fill two syringes with 2 to 3 ml of normal saline solution.
  4. Administer medication.
  5. Clean lock's injection port with antiseptic swab.
  6. Insert syringe with normal saline solution through injection port of IV lock.
  7. Pull back gently on syringe plunger, and check for blood return.
  8. Flush IV site with normal saline solution by pushing slowly on plunger.
  9. Remove saline solution-filled syringe. Clean lock's injection port with antiseptic swab.
  10. Insert syringe containing prepared medication through injection port of IV lock.
  11. Inject medication over time required by institutional policy, pharmacist, or medication manual. Use a watch to time administration.
  12. After giving medication, withdraw syringe. Clean lock's port with antiseptic swab.
  13. Flush injection port by injecting normal saline flush at same rate as medication.
  14. Flush injection port with heparin (optional): After instilling saline solution, inject heparin flush slowly. Then remove syringe.
  15. Dispose of used supplies, remove gloves, and perform hand hygiene.
  16. Observe patient closely for adverse reactions and injection site swelling
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