MedSurg Guide: Dosage Calculations, IV Medications, Blood Transfusions, and Parenteral Nutrition Therapy

Dosage Calculations (PowerPoint)  IV Solutions  Provides rapid therapeutic effect  Can lead to immediate serious reactions  Isotonic: parenteral solution within osmolarity of 270-300 mOsm/L.  When infused, fluid d/n move into or out of body cells. Pt is at risk for fluid overload.  Hypertonic: fluids greater than 300 (parenteral nutrition is this)  Used to correct fluid and electrolyte and acid-base imbalances by moving water out of the bodies cells into the blood stream.  Hypotonic: fluids less than 270  Fluid moves into the cells.  IV and IV Push Medications  IV Push  IV push medications are injected directly into the IV port using a syringe.  Flush the line before and after giving med with 10 ml of normal saline or per facility protocol  Adverse Reactions  Severe adverse reactions may occur quickly  Hypersensitivity to IV medications can occur immediately  *The most severe reaction is anaphylaxis  Dramatic and acute, marked by sudden onset of rapid articaria and respiratory distress  *The most common anaphylaxis causing medication is Penicillin at parental administration  Nursing Responsibilities  Medication indications and proper dosage  Contraindications and precautions  Appropriate dilution, rate of infusion, pH & osmolarity, and compatibility with other IV meds  Never assume that IV administration is the same as giving the medication by other routes  Preparing Medications for IV administration, follow these safety rules:  Check expiration date  Maintain sterile technique  Inspect the medication, diluent, and solution for particles or cloudiness  Documentation  Nursing Responsibilities o Six Rights  Right medication  Right dose  Right time  Right client  Right route  Right documentation; document immediately after giving the medication, if not given indicate why on the MAR and nursing notes o Three Medication Checks  Check #1: compare the med label to the MAR as you remove the medication from the storage area  Check #2: compare the med label to the MAR as you prepare each medication This.....