1. N26: IVPB
Spring 2012
Terminology
Piggyback: general term meaning ‘attach 1 tubing to another’
Continuous vs Intermittent
Secondary Tubing
Y-site
Volume Controlled set
Cabrillo College ADN/C. Madsen RN, MSN

2. Advantages IV route Direct (and instant) access to circulatory system
N26: IVPB
Spring 2012
Advantages IV route
Direct (and instant) access to circulatory system
Able to give drugs too irritating for gastric mucosa – or for delivering high concentrations
Since IVPB (“intermittent”) usually over 30 – 60 min, can instantly d/c if reaction occurs
Able to give meds when GI tract not available
Cabrillo College ADN/C. Madsen RN, MSN

3. Disadvantages of IV route
N26: IVPB
Spring 2012
Disadvantages of IV route
Drug interactions because of incompatibilities
Sometimes drug absorbed by plastic container – full dose not delivered
Speed shock
Tissue injury – chemical phlebitis or when certain drugs infiltrate
Cabrillo College ADN/C. Madsen RN, MSN

4. Before hanging med: Check expiration date on secondary tubing.
N26: IVPB
Spring 2012
Before hanging med:
Check expiration date on secondary tubing.
Does tubing have sterile cap?
5 rights, plus
rate of administration
compatibility of IV solution
clean access (Y-site) ports with alcohol prior to each access.
Cabrillo College ADN/C. Madsen RN, MSN

5. Compatibility & Rate of Administration
N26: IVPB
Spring 2012
Compatibility & Rate of Administration
Drug books
Davis’s Drug Guide: each drug divided into sections; find “IV Administration” section
“intermittent administration” & compatibility
Gahart: information under Dilution, Rate of Administration, Compatibility
Intermittent IV (vs IV injection or infusion)
Pharmacy
Cabrillo College ADN/C. Madsen RN, MSN

6. Ondansetron HCL (Zofran) (Gahart & Nazareno, Intravenous Medications)
N26: IVPB
Spring 2012
Ondansetron HCL (Zofran) (Gahart & Nazareno, Intravenous Medications)
Dilution
IV injection:…
Intermittent infusion: single dose should be diluted in 50 mL of NS or D5W. Also available…
Compatibility
Additive
Y-site
Rate of Administration
IV injection…
Intermittent infusion: single dose over 15 min.
Cabrillo College ADN/C. Madsen RN, MSN

7. Primary IV on Infuser pump
N26: IVPB
Spring 2012
Primary IV on Infuser pump
Y-site above the pump (‘rate controller’)
Backprime
“piggyback” or “secondary” function key
Rate
VTBI
Cabrillo College ADN/C. Madsen RN, MSN

8. N26: IVPB
Spring 2012
Primary IV to gravity
Dial-a-flow or stat-master = the ‘rate controller’
Y-site above rate controller
Set at desired ml/hr AND check gtts/min to verify accuracy.
Maintenance solution stops while infusing an intermittent med attached above the pump or dial-a flow
Cabrillo College ADN/C. Madsen RN, MSN

9. After hanging med Make sure it is infusing Check on pt after 5-10 min
N26: IVPB
Spring 2012
After hanging med
Make sure it is infusing
Have you opened the clamp?
Check on pt after 5-10 min
6th right: document
Cabrillo College ADN/C. Madsen RN, MSN

10. Syringe Pump “spaghetti” tubing Note where flange of syringe goes
N26: IVPB
Spring 2012
Syringe Pump
“spaghetti” tubing
Note where flange of syringe goes
Attach closest to IV insertion site (below the ‘rate controller’)
Maintenance solution does not stop
May also connect to SL; then use SAS
Cabrillo College ADN/C. Madsen RN, MSN

11. Saline Lock Saline Administer med
N26: IVPB
Spring 2012
Saline Lock
Saline
Administer med
Used with Syringe pump, gravity tubing, or EID
May or may not use “backup” solution (usually NS)
Tubing may be on pump, and needs to be connected; may connect regular gravity tubing directly to Saline Lok.
Cabrillo College ADN/C. Madsen RN, MSN

12. What if solution is incompatible?
N26: IVPB
Spring 2012
What if solution is incompatible?
Use Primary tubing and connect to lower Y-site
Turn off primary IV
Flush with saline before and after or
Disconnect primary IV, hang NS and use secondary tubing.
Cabrillo College ADN/C. Madsen RN, MSN