Post on 29-Nov-2014
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Administration & Calculation of
Drugs, IV fluids, Blood & Blood Components
Mohammed Alhabsi IndananClinical Instructor
King Abdul Aziz Specialist Hospital
Taif, Kingdom of Saudi Arabia
King Abdulaziz Specialist Hospital-Taif
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Administration of Drugs
1. Medication Ordering2. Medication Transcription3. Medication Administration4. Medication Documentation5. Unused Medication6. Medication Safety
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Administration of Drugs
1. Medication Ordering Written Orders Verbal Orders Telephone Orders Unclear Order
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Administration of Drugs Administration of Drugs
2. Medication Transcription
3. Medication Administration: RN Standard medication time/with approved used
of abbreviation Do NOT use the Kardex to medicate Report unexpected reaction, Medication Error Error in preparation by the pharmacist
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Administration of Drugs
Observe the 7 rights 30 minutes before and or 30 minutes after the
specified time ONLY. Observe & document adverse reaction Labeled open medication Weight 2 RN’s Check the ff. medication;
Narcotic & Controlled drugs, Anticoagulants, Chemotherapeutic drugs, Digoxin, Mg. Sulfate, K Chl., Heparin, Insulin, Aminophylline for pediatrics and all other High-Risk medications
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Administration IV Fluids
Intravenous Therapy:Intravenous Therapy: Introduction of fluids, blood, drugs directly into
the vascular system for therapeutic & diagnostic purposes.
Intravenous FluidIntravenous Fluid:: Those fluids which are administered into the
circulatory system through a vein.
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Administration IV Fluids
RN follow IV therapy protocol, including Infection Control guidelines
Only RN passed written test on med. Calculation & IV therapy
Completed 3 cannulations under supervision Antibiotics in NICU: used SOLU-set IV Digitalis & Narcotics: IV push given only in
high risk area with cardiac monitoring Strict aseptic technique Verified order Response to IV therapy
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Drug Calculations
Total volume to be infused X drop factor
Total hour X 60mins
500ml X 20
8 hours X 60
20.8 or 21 gtts/min
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Drug Calculations
DH
25mg
100mg
0.5 ml
X Q
X 2ml
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Blood & Blood Components
BT- introduction of blood and/or its derivatives into the circulation
Ordering: Product type Amount Flow rate & transfusion time Date & time of administration Signed consent Request form must be fully completed
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Blood & Blood Components
Blood Products Availability:
Whole blood 450ml
Packed RBC 200ml
FFP 150ml
Platelets 50ml
Cryoprecipitate 50ml
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Blood & Blood Components
Packed RBC Not be hang for more than 4 hours
Platelet Concentration Administer quickly as possible but within not
more than 30 minutes Collected one at a time 150-280 micron filter Y type MUST be used.
FFP Administered as quickly as possible but within
less than 4 hours
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Blood & Blood Components
Cryoprecipitate Administered as quickly as possible but within
not more than 4 hours All blood products directly transfuse & heparin
Lock must be removed. Recommended gauge:
Adult : 18-20 Paediatric: 22-24 Neonate: 24-26
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Blood & Blood Components
New blood transfusion set for every unit of blood.
Infusion pump for paediatric patients, if not available Solu-set infusion with FILTER.
2 RN’s or RN together with a Physician will verify pt’s identity
Blood products shouldn’t stored in unit refrigerator
Check V/S Used NSS for priming If not started immediately, return to blood bank.
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Blood & Blood Components
Patient Identification before starting transfusion Compare pts data in BT request Confirm ABO & Rh compatibility by
comparing/checking: The bag label Expiration date Satisfactory serology testing Physician’s order sheet BT request form
The physician’s check the blood & request form & affix stamp & signature on the BT request before commencing transfusion.
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Blood & Blood Components
Initiation: Inform & explain the procedure as well as desired
outcome Obtain & record baseline V/S Hold if 38 degree Inspect abnormal color, cloudiness, clots and present of
air. Check the expiration date written on the bag Start infusion at 2ml/min Stay with the pt for the 1st 15-30mins. Increased according to prescribed rate Check V/S for the 1st 15mins. Check Pulse 30mins., BP
hourly, temp. 2 hourly Report signs of reaction immediately.
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Blood & Blood Components
Transfusion Reaction Response: Stop BT immediately Change tubing and start Infusion NSS Notify physician, Nsg. Supervisor Check & Verify identification Monitor & record V/S Obtain blood sample from pt & distribute withdrawn
sample to the ff. tubes to be sent to Hematology, Chemistry & Blood Bank
Collect urine specimen Send blood bag with infusion set to Blood Bank with
blood sample Document Initiate and write OVR
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