RNSG 1119 - Trinity Valley Community College



MODULE VIII – INTRAVENOUS THERAPY PROCEDURES

A. VENIPUNCTURE

|Behavioral Objectives |Skill Content |Learning Opportunities |

|Demonstrate the correct procedure of collecting blood by |Collecting blood specimens by venipuncture. |Practice venipuncture on the equipment available in skills lab. |

|venopuncture. | | |

| | |Have a peer review our technique drawing blood. |

|Describe the nursing responsibilities for processing blood | | |

|specimens after collection. | |View: |

| | |a. TVCC Library – Nursing Education in Video |

|Identify the proper tubes to be used for specific laboratory | | |

|tests. | |Basics and Venipuncture in Intravenous Therapy Episode 1 (Inc. Medcom, 2012 |

| | |b. Internet |

| | | |

| | | ture |

MODULE VIII - INTRAVENOUS THERAPY PROCEUDRES

B. INITIATING AND MANAGING

|Behavioral Objectives |Skill Content |Learning Opportunities |

|Discuss conditions require IV therapy. |Berman and Snyder text: |Read: |

| | |Applicable pages in Harkreader |

|Describe considerations to be included in selection of a venipuncture |Skill 52 - 1 Initiation Intravenous Therapy. Checklist in|Applicable pages in McKinney |

|site. |syllabus. |Applicable pages in Lewis |

| | | |

|Identify common veins used for insertion. |Skill 52 – 2 Monitoring the Intravenous Infusion, Chapter |View: |

| |26. |Mosby’s Nursing Video Skills |

|Identify types of cannulas used for venipuncture and describe | |Advanced: IV Fluid Therapy Administration |

|considerations in the selection of each. |Converting a primary intravenous access to a heparin or |Advanced: Management of IV Fluid Therapy |

| |saline lock. |Advanced: IV Med Administration |

|State variations in technique, site selection, equipment and | |b. MyNursingLab: Real Nursing Skills 2.0 |

|stabilization. |Skill 35 - 8 Adding Medications to an IV Solution. |Starting an IV; Medication Administration by Intermittent Infusion |

| | |c. TVCC Library – Nursing Education in Video |

|Identify types of equipment and solutions used for IV infusion. |PICKAR: | |

| |Regulating Flow Rate Manually. |Pediatrics in Intravenous Therapy Episode 4 (Inc. Medcom, 2012) |

|Discuss various intravenous access devices, PICC lines, central lines,|Infusion Pumps. |Recognizing and Treating Complications in Intravenous Therapy Episode 3 (Inc. |

|& peripheral lines. | |Medcom, 2012) |

| | |Routine Care and Discontinuation in Intravenous Therapy Episode 2 (Inc. Medcom, |

|Describe special precautions for maintaining the integrity of IV | |2012) |

|systems with infants and children. | |Practice all procedures. |

| | |Have two peers review your technique for starting an IV. Use checklists in |

|Demonstrate the procedure for initiating and managing IV infusions, | |syllabus. |

|including changing bag and tubing, adding medication, time taping, and| |Have a peer evaluate your ability to add medication to an IV, convert IV to |

|calculating drip rate. | |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. |

|Calculate the drops per minute and milliliters per hour of IV | |Have an instructor evaluate your technique for attaching a saline lock device, |

|solutions. | |adding medication to an IV, regulating drip rate, and discontinuing an IV. |

| | |Document IV start, saline lock, and dc IV on IV Flow Sheet. |

|Calculate small volume IV piggybacks. | |Have a peer review your understanding of Obj #’s 6, 7, 8, & 9. |

| | | |

|Discuss various dosages of Heparin. | | |

| | | |

|Demonstrate the procedure for calculating dosages of medications | | |

|delivered by infusion over a specified time period. | | |

| | | |

|Discuss potential complications of IV therapy and associated nursing | | |

|interventions. | | |

MODULE VIII – INTRAVENOUS THERAPY PROCEDURES

C. INTRAVENOUS PIGGY BACK (IVPB)

|Behavioral Objectives |Skill Content |Learning Opportunities |

|Identify compatibility considerations in preparing and |Berman and Snyder text: |Read applicable pages in Berman and Snyder. |

|administering IV fluids and medication. | | |

| |Text, pages 896-899. IV medication by intermittent infusion |View: |

|Identify the rationale for difference in rate of infusion for IV |(through existing line and through intermittent infusion device or |Mosby’s Nursing Video Skills |

|solutions containing medications. |peripheral lock). |Advanced: Intravenous Fluid Therapy Administration |

| | |Advanced: Management of IV Fluid Therapy |

|State the purpose of a controlled volume administration set. |SKILLS LAB: |Advanced: IV Med Administration |

| |Controlling flow using a stopcock. |b. TVCC Library – Nursing Education in Video |

|Apply the nine cardinal rules of safety in preparing and | | |

|administering IV drugs: |Volume Control Infusion, pg. 898 Figure 35 – 48. |Pediatrics in Intravenous Therapy Episode 4 (Inc. Medcom, 2012) |

|Five rights. | |Recognizing and Treating Complications in Intravenous Therapy Episode 3 (Inc. |

|Compatibility. | |Medcom, 2012) |

|Length of administration time. | |Routine Care and Discontinuation in Intravenous Therapy Episode 2 (Inc. Medcom, |

|Amount of medication added. | |2012) |

|Dilution of solution. | |Pain Treatment Programs for Special Populations in Pain Management and Patient |

| | |Care (Medcom Inc., 2009) |

|State the advantages and disadvantages of using intermittent | |General Recommendations for System-wide Change (Part 1) in Preventing Medication |

|infusion devices/peripheral lock. | |Errors Episode 1 (Medcom Inc., 2009) |

| | |Sources of Errors and Basic Safety Practices (Part 2) in Preventing Medication |

|Explain the rationale for flushing the heparin lock with saline | |Errors Episode 2 (Medcom Inc., 2009 |

|or with a heparin solution. | |Basics and Venipuncture in Intravenous Therapy Episode 1 (Inc. Medcom, 2012) |

| | |Practice your technique on administering medications by volutrol, secondary set, |

|Demonstrate the procedure for administering and managing and IVPB| |and intermittent infusion device. |

|medication through a peripheral lock or existing IV line. | | |

| | |Have a peer review your technique on administering medications by volutrol and |

| | |using a stopcock. |

| | | |

| | | |

| | |Have two peers review your technique administering IV medications by secondary |

| | |set and intermittent infusion device. |

| | | |

| | |Have an instructor evaluate your technique administering IV medications by |

| | |secondary set and intermittent infusion device in a group. |

| | | |

| | |Document IVPB on MAR. |

| | | |

MODULE VIII – INTRAVENOUS THERAPY PROCEDURES

D. INTRAVENOUS PUSH (IVP)

|Behavioral Objectives |Skill Content |Learning Opportunities |

|State four purposes for administering a medication IV Bolus. |Berman and Snyder: |Read applicable pages in Berman and Snyder |

| | | |

|Explain why IV bolus is the most dangerous method of drug |Skill 35 - 9 Administration of Intravenous Medications as a Bolus |View: |

|administration. |Dose |Mosby’s Nursing Video Skills |

| |Note: When preparing medication for IVP, you will dilute unless |Advanced: Intravenous Medication Administration |

|Identify how to administer IV bolus medication through a |contraindicated. |b. MyNursingLab: Real Nursing Skills 2.0 |

|peripheral lock and existing IV line. |(Checklist in syllabus.) |Starting an IV; Medication Administration by Intermittent Infusion |

| | |c. TVCC Library – Nursing Education in Video |

|Identify potential complications for clients receiving IV bolus |Using an Intermittent Device, page 899 | |

|medications. | |Pediatrics in Intravenous Therapy Episode 4 (Inc. Medcom, 2012) |

| |Patient Controlled Analgesia, pgs. 1029-1030 |Recognizing and Treating Complications in Intravenous Therapy Episode 3 (Inc. |

|Identify actions to correct complications for clients receiving | |Medcom, 2012) |

|IV bolus medications. | |Routine Care and Discontinuation in Intravenous Therapy Episode 2 (Inc. Medcom, |

| | |2012) |

|State the result of too rapid infusion of an IV push medication. | |Pain Treatment Programs for Special Populations in Pain Management and Patient |

| | |Care (Medcom Inc., 2009) |

|State key nursing considerations for IV administration of the | |General Recommendations for System-wide Change (Part 1) in Preventing Medication |

|following medications including: | |Errors Episode 1 (Medcom Inc., 2009) |

|Generic and trade names. | |Sources of Errors and Basic Safety Practices (Part 2) in Preventing Medication |

|Classification. | |Errors Episode 2 (Medcom Inc., 2009 |

|Action. | |Basics and Venipuncture in Intravenous Therapy Episode 1 (Inc. Medcom, 2012) |

|Indications and dosage. | |Practice administering IV bolus medications via intermittent infusion device and |

|Adverse effects; contraindications. | |IV infusion line. |

|Interactions with lab and drugs. | | |

|Nursing interventions and considerations. | |Review the medications listed in Objective 7 in your drug book. |

|Patient teaching needs. | | |

|digoxin (Lanoxin). | |A drug book with IV considerations is required for check-off and in clinical. |

|furosemide (Lasix). | | |

|meperidine (Demerol). | |Have two peers review your ability to administer IV medication via intermittent |

|metachlorapromide (Reglan). | |infusion device and IV infusion line. |

|methylprednisolone (SoluMedrol). | | |

|morphine sulfate (Morphine). | |Have an instructor evaluate your ability to administer IV medication via |

|phenytoin (Dilantin). | |intermittent infusion device and/or IV infusion line in a group. |

| | | |

| | |Be prepared to answer specific questions listed on sample IV push order page in |

| | |syllabus. |

| | | |

| | |Document procedure in nurses’ narrative notes and MAR. Turn in for evaluation. |

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MODULE VIII - INTRAVENOUS THERAPY PROCEDURES

E. BLOOD ADMINISTRATION

|Behavioral Objectives |Skill Content |Learning Opportunities |

|List risks associated with blood transfusions. |Berman and Snyder |Read: |

| | |Applicable pages in Berman and Snyder. |

|Describe safety precautions in checking blood products prior to |Skill 52 – 6 Transfusion of Blood Components. Checklist in |Applicable pages in Lewis, pages 706 - 707. |

|administration. |syllabus. |2. View: |

| | |a. MyNursingLab: Real Nursing Skills 2.0|

|Identify compatibility considerations in administering blood |Review blood transfusion flow sheet. |, Administering IV therapy; Initiating Blood Therapy |

|products. | |b. TVCC Library – Nursing Education in Video |

| | | |

|State the protocol necessary to obtain blood products in the | |Informed Consent: Basic Principles for Staff Education (Medcom Inc., 2004) |

|hospital setting. | |3. Practice inspection of blood products and administration of blood products |

| | |using the Y-set. |

|State the baseline data to be obtained prior to transfusion. | | |

| | |4. Have two peers review your technique in administering blood using checklist |

|State signs and symptoms that can indicate adverse reactions to | |in syllabus. |

|blood. | | |

| | |5. Have an instructor evaluate your techniques in blood administration in a |

|Identify nursing actions to be done if an adverse transfusion | |group. |

|reaction is suspected. | | |

| | |6. Answer blood transfusion questions provided in syllabus. |

|Explain the indication for use of pressure sleeves and blood | | |

|warming devices in administering blood products. | |Document procedure in nurses’ narrative notes and turn in for evaluation. |

| | | |

| | |8. Complete blood transfusion flow sheet and turn in for |

| | |evaluation. |

MODULE VIII – INTRAVENOUS THERAPY PROCEDURES

F. CENTRAL VENOUS LINES

|Behavioral Objectives |Skill Content |Learning Opportunities |

|State the uses for central venous catheters. |Berman and Snyder: |Read: |

| | |Applicable pages in Berman and Snyder. |

|Define Total Parenteral Nutrition (TPN) and hyperosmolarity. |Changing the Dressing for a Central Line Catheter, pages 1496 - |Applicable pages in McKinney, pages 982-983. |

| |1498. |Applicable pages in Lewis, pages 328-330. |

|Describe clinical situations in which hyperalimentation may be | | |

|indicated. |Changing the IV solution and Tubing for Central Venous Catheter. |View: |

| | |Mosby’s Nursing Video Skills |

|Identify potential complications for patients with subclavian or |Flush unused ports. |Advanced: Vascular Access |

|jugular lines. | |b |

| |Checklist in syllabus. |c. TVCC Library – Nursing Education in Video |

|Identify complications for patients receiving TPN or | | |

|hyperalimentation and nursing actions to prevent these | |National Patient Safety Goals 2012 (Medcom Inc., 2011) |

|complications. | |Never Events and Hospital-Acquired Infections: Prevention Practices in Never |

| | |Events and Hospital-Acquired Infections (Medcom Inc., 2009) |

|Describe the purpose and complications of flushing unused ports | |Practice changing a central line catheter dressing and changing the IV solution |

|in a multi-lumen catheter. | |with new tubing and flush |

| | |unused ports. |

|Demonstrate care of a central line catheter including changing | | |

|solution, tubing and dressing changes. | |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. |

| | | |

| | |Have an instructor evaluate your technique in changing a central line catheter |

| | |dressing, changing the IV solution, tubing, and flush unused ports. |

| | | |

| | |Document changing solution, tubing and dressing changes on IV flow sheet. |

N/ADN Syllabus/Transition/Module VIII Revised 04/13

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