drug administered through peripheral and central veins

-provides immediate effect

-most dangerous

-emergency

-clients have disorders that affect absorption

-blood levels of drugs need to be maintained at a consistent level

-client decides to avoid repeated injections 

-a mechanism is needed to give drugs a long time (cancer)

instillation of a parenteral drug over several hours, (continuous drip)

adds medication to large volume of iv solution

is short term administration of medication (from minutes up to an hour)

undiluted medication given quickly into a vein (iv push) 

-no info, give it 1ml per minute 

-given through a port in an existing iv port, or through a medication lock 

is a sealed opening that extends from the iv tubing.

-a substance that can be pierced with a needle

called a saline or heparin lock 

or an intermittent infusion device

-a plug that when inserted into a iv alows instant access into venous system

- flush it every 8-12 hours

-change it at least every 72 hours

a guide to to the steps involved in administering iv medication

S= saline

A=administration

S= saline

the H=heparin

the administration of a parenteral drug that has been diluted in a small volume of iv solution(50 to 100 ml) over 30 to 60 minutes. 

"piggyback infusion"

is a set chamber in iv tubing that holds a portion of the solution from a larger container

- it is used to administer iv solution in a small volume of solution at intermittent intervals and to avoid accidentally overloading

venous device that extends to the superior vena cava

clients require long term iv

iv's are irritating to the peripheral veins

difficult to insert and maintain a peripheral iv

three types of cvc's

percutaneous

tunneled

implanted 

percutaneous catheter

is inserted through the skin in a peripheral vein.

used for short term clients

are inserted into a central vein with part of the catheter secured in the subcutaneous tissue. 

-end of the catheter exits the skin lateral to the xiphoid process

-extended therapy clients

-reduces infection, internal cuff acts as barrier

-sealed beneath the skin,

-provides greatest protection against infection

-a self sealing port pierces through the skin

-local anesthetic is applied to skin

2,000 punctures

medications used to destroy 

or slow the growth of malignant cells "chemo"

-toxic to both normal and abnormal cells

-adverse effects in pharmacists and nurses

cover drug area with disposable pad

-wear a protective gown

-wear two pairs of gloves

-mask, respirator, goggles if necessary

-pour 70% alcohol over any drug spill

-clean at least three times

gerontologic considerations

-veins are fragile, percutaneous central vein is better than failed peripheral catheters

- metabolize and excrete drugs at a lower rate

-older peopel have more "free drugs" in their vein, because of low protein counts in blood