Student Assessment: Tasks 1 and 2 - IV Medication Administration and Electrolyte Imbalance

Running Head: STUDENT ASSESSMENT: TASKS 1 AND 2
STUDENT ASSESSMENT: TASKS 1AND 2.
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STUDENT ASSESSMENT: TASKS 1 AND 2
Q1. What drug schedule is medication which is administered IV? Refer to drugs and
poison schedules by law
IV medications are an example of prescription-only medicines. They are classified under the
schedule IV of the drugs and poisons schedule of Australia (Schipp, 2012). These drugs are
prepared for therapeutic use. Their administration, however, requires supervision from a
professional medical practitioner (used to mean a qualified doctor, nurse, pharmacist). The
efficacy and safety of these drugs require further assessment to determine their potential to cause
harm to the patient (Australian government therapeutic goods administration. Scheduling basics,
2011).
Q2. What is the rationale for a doctor to prescribe medication to be administered IV? Take
into consideration bioavailability of drugs?
The reasoning behind the prescription of medications that are administered by IV is to achieve
the desired therapeutic effect as quickly as possible. IV administration releases drugs directly
into the bloodstream where they are distributed and carried to their target site for action ( Keers
et al., 2013). Before the prescription, a doctor considers the following: the health status of the
patient, to determine whether a rapid response is needed, the properties of the medication, since
some medicines are only feasible when administered intravenously, the dosage, etc. (The
Nursing Times, 2007).
Q3. You are required to administer blood/blood product to a patient. What is the protocol
for this procedure? Including storage of blood. What fluids are not compatible with
blood/blood products?
To begin with, I will check the identity of the patient and the blood bag in the presence of a
doctor or another nurse, to eliminate any possibility of transfusion errors, such as blood group

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incompatibility. I will then inspect the guidelines for rate of transfusion, and then obtain the
blood or blood samples from storage and administer it immediately using a new sterile blood
administration set in accordance with the instructions given by Klein and Anstee (2014). I will
then follow the progress of the transfusion and record it accordingly. Before and after
transfusion, I will confirm that the accepted blood storage instrument is operating optimally and
then store the blood in the required conditions in a refrigerator blood bank (Epstein, 2012).
Q4. What education will you give to your patient before you commence IV fluid
administration? Including possible side effects?
I will tell the patient the circumstances under which an IV therapy is done, and why it is being
performed to them. I will also inform them that the catheter is held in place using a transparent
dressing to facilitate the observation and monitoring of the IV site. I will urge them to alert me or
any other attendant in case they feel itched at the IV site, or when the site becomes red, or it
swells. I will tell them that the swelling, redness, itching, bleeding, or pain are signs of
undesirable effects. Furthermore, I will say to them that, the IV pump has an alarm and informs
them the purpose of the signal. I will urge them not to reinsert the IV catheter back in place if it
is pulled out but should alert the doctor or myself immediately.
Q5. What are the common sites for jelco/cannula insertion? How are you going secure the
cannula in place?
The sites include metacarpal veins, the dorsal vein network axillary basilic vein scalp veins such
as occipital veins and posterior auricular vein, the antecubital fossa, and the dorsal venous arch
and venous plexus of the foot. The cannula will be held in place by using a sterile tape. It will be
attached to the skin in such a way that it does not cause discomfort to the patient, and also stays
in place( lopez and Reyes-Ortiz, 2010).

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STUDENT ASSESSMENT: TASKS 1 AND 2
Q6. What are the nursing considerations before IV medication administration?
Prior to an IV administration, the nurse in charge should be well informed on the patient’s
medical history (Dabliz and Levine, 2012). The considerations include allergic reaction to the
drug, possible local reaction, urticaria, dyspnea, angioedema, and nasal congestion (Carlson,
1986). The nurse ensures that the IV catheter is placed correctly, to avoid irritation and vascular
damage caused by the push drugs. The nurse should also confirm that the right dosage is
administered and monitor the patient since IV medications tend to act rapidly ( Trim and Roe,
2004).
Q7. What are the 8 Rs for IV medication administration?
The rights of medication administration are recommendations that have been put in place to
minimize medical errors. They are: right patient, which ensures that the is medication is given to
the right patient; the correct route, where the nurse checks the order appropriateness of the path
of drug administration and ensures that they can receive the medication by the ordered route; the
right time of administration; the correct documentation to eliminate confusion; the right reason;
the right dosage; the right medication; and right response, where the patient is monitored for the
desired outcome (Kuperman et al., 2001).
Q8. What is the checking procedure for IV medication administration to prevent
medication error?
The checking procedure is a guideline that helps nurses to avoid medication errors. To ensure no
mistakes occur during IV medication administration, ensure that; the five rights of medication
administration are followed, proper medication reconciliation procedures are followed, double-
check the process before drug administration, IV medications are appropriately stored before,
and after use, the needles and catheter tubing to be used are new and sterile, and document

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everything clearly, always have a drug guide and in the correct manner (Alsulami, Choonara and
Conroy, 2014)
Q9. Before you administer IV medication what risk assessment you need to perform?
Evaluation of risks is done to point out the causes of errors and to establish an appropriate
preventive mechanism. Risk assessment helps the nurse avoid human errors that often occur
during drug administration (Cohen, 2007). It is carried out prior to IV medication, to ensure that
the medication is administered successfully to prevent any form of discomfort or even death to
the patient. The following will be checked; the volume of the medication, drug compatibility, the
rate at which the medication will be administered, the type of solvent used, and the additives
included (Westbrook et al., 2011).
Q10. How are IV medications stored? Include schedule drug 8.
Medicines are poisons and must be treated as such. All medications come with an expiry date
and guidelines for appropriate storage. Conditions for storage such as temperature, humidity,
duration should be adhered to for proper drug storage. The storage requirements for each drug
are to be applied to that drug alone because different drugs have different constituents which
confer various properties to the drug. Schedule 8 drugs are controlled medications. These drugs
have a high likelihood of being abused and causing addiction and must be appropriately secured
from the reach of patients, medical practitioners, and visitors ( Ewen et al., 2015).
. Q11. IV medication has 100% availability, why may doctor prescribe to monitor “trough
and peak” of a particular IV medication? Explain what the terminology means? Give 2
examples of drugs which require trough and peak levels.
The trough phase is the lowest concentration of a drug in a patient’s blood. The peak on the other
hand refers to the highest level a drug in the patient’s blood. For adequate medical care,

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therapeutic agents must be monitored properly. A doctor will prescribe to monitor the trough and
peak of a particular medication to help in the evaluation of the dosage levels of the drugs to be
administered and to determine whether an IV medication is consistently within the therapeutic
range. To assess the concentration of a drug during the trough, a specimen is taken before drug
administration, whereas during the peak phase, specimen collection is dependent on the route of
administration. Examples of peak and trough drugs are phenobarbital and digoxin.
Q12. Your patient is complaining of pain at site of jelco/cannula insertion. What you going
to do? State your actions including documentation
Pain is an early symptom of phlebitis and is an indication that the peripheral intravenous cannula
(PIVC) has malfunctioned. In this situation, I will remove the PIVC. I will then consider
inserting another catheter, in case the patient is still in need of a cannula. I will then place the
arm on the pillow, so that it rests in an elevated angle, and apply hot or cold packs to relieve the
inflammation and also offer paracetamol to the patient. I will then continue to monitor the
progress of the patient and document the cause of the pain and the progress of the patient after
the corrective measure.
Q13. Explain the difference of these types of solutions and state reason why and when they
would be administered, give an example for each:
Isotonic Solution is a solution that contains the same amount of solutes and water relative to the
cell’s cytoplasm. Isotonic solutions are administered to increase the volume of the extracellular
fluid, for instance, after surgery, blood loss, dehydration, etc.
Hypotonic Solution: is a solution whose concentration is lower than that of the cell’s interior.
When placed into a hypotonic solution, the cell takes up water via osmosis and swells.
Hypotonic solutions are administered in circumstances of cell dehydration, to bring the osmotic