Accessing a venous access device to give an IV push medication
Question
A nurse will give an IV push medication through a client's saline-locked venous access device that has a needleless connector. Place the steps in the order the nurse should perform them, starting with the first step.
Correct order
- Vigorously scrub the needleless connector with an antiseptic swab and let it dry
- Attach a saline syringe, aspirate for blood return, and slowly flush to check patency
- Scrub the connector again with a new swab and let it dry
- Attach the medication syringe and give the drug at the recommended rate
Answer
1. Vigorously scrub the needleless connector with an antiseptic swab and let it dry → 2. Attach a saline syringe, aspirate for blood return, and slowly flush to check patency → 3. Scrub the connector again with a new swab and let it dry → 4. Attach the medication syringe and give the drug at the recommended rate
Rationale
The connector is disinfected and allowed to dry before every access, so the first scrub comes before the saline syringe touches it. Patency is confirmed with the saline flush before any drug is given. The connector is then scrubbed again with a new swab because it is being accessed a second time, and only then is the medication syringe attached.
Sources
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- Adapted from Open RN Nursing Advanced Skills: Chapter 2 Administer IV Push Medications
- Adapted from Open RN Nursing Skills, 2nd edition: Chapter 23 IV Therapy Management
- Maintenance and Removal of (Source: CDC)
- Adapted from Open RN Nursing Advanced Skills: Chapter 4 Manage Central Lines
- Appendix: Recommendations for Prevention and Control of Infections in (Source: CDC)
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