Question

An elderly client has an order for 1,000 mL D5W at 100 mL/hr. The nurse assigned to the client attached IN tubing to the IV with drop factor of 10 gtt/mL without checking the package of IV tubing. As a habit of the previous institution where she worked, the IV floe rate was calculated based on drop factor 20 gtt/mL. At the beginning of the next shift, the nurse making rounds noticed that the client was having difficulty breathing and seemed restless. When the nurse checked the IV rate, she discovered the rate was 33 macrogtt/min of 17 macrogtt/min.

Answer the following questions:
a) What factors contributed to the error?

b)How did the IV rate contribute to the problem and why?

c)What should have been the action of the nurse who attached the IV tubing in relation to the IV administration?

Answer 1

Ans) a) The maximum flow rate achievable may be influenced by several factors, including the diameter of the cannula, the nature of the fluid and the pressure at which it is administered. Patients commonly receive intravenous infusions of both fluids and drugs peri-operatively.

b) There are times when a fast IV drip is necessary. This usually occurs when the patient has already lost a great deal of blood volume, either through dehydration or blood loss. That way, blood volume can be increased at a more rapid pace. This gives the patient a better chance of survival in most cases.

c) Use a blunt filter needle or blunt needle when preparing injections. Never use a needle when injecting IV medication. Always use a needleless system. After preparing the medication, always label the medication syringe with the patient name, date, time, medication, and dose.

- Using aseptic technique and changing the tubing at the same time a new primary fluid bag is hung are both appropriate to minimize the patient's risk for infection 13. While changing a patient's hospital gown, the extension set on the IV infusion becomes disconnectedand ends up on the bed linens.

- The nurse must administer the IV medication exactly at the prescribed rate over the required after administration for intended as well as potential adverse effects of the medication.