Adding Medication to an IV Solution

• Review medication orders, and check for drug allergies.

• Verify compatibility of drug to be admixed with IV solution.
• Wash hands.
• With an alcohol swab, cleanse injection port on IV solution bag.
• Insert needle into port, and inject medication.

Figure 1: Adding medication to an IV solution.

Source: Kozier et al., 2000, p. 789.

• Withdraw syringe from port.

• Gently rotate IV bag to mix solution.
• Inspect solution for any precipitate. If present, do not use solution.
• Clearly note date, time, medication, and dosage of additive on medication label.
Place label on IV bag so it can be easily read when the bag is hung.
• Insert IV tubing into bag, prime IV tubing, and administer as ordered.

Administering an IV Piggyback (IVPB)

• Review medication orders, and check for drug allergies.

• Verify compatibility of drug to be administered with infusing IV (primary solution).
• Wash hands.
• Identify client by checking armband.
• Assess infusion site for patency.
• Add secondary infusion set to IVPB bag, affix needleless cannula to end of
secondary tubing, and prime tubing.
• Hang secondary bag (IVPB) on IV pole. Use extension hook to lower primary
bag. (Some infusion pumps do not require this.)

Figure 2: Hang primary solution lower than

secondary piggyback.
Source: Smith et al., 2000, p. 870.
 • With alcohol swab, cleanse Y-site injection port of primary infusion tubing.
• Insert needleless cannula into Y-site injection port of primary tubing. If primary
solution is infusing via pump, connect in port above pump.
• Program infusion pump to deliver medication at desired infusion rate, and open
clamp of secondary (IVPB) tubing.
• Manually adjust drip rate if not on pump.

Administering IV Medication Through A Volume Control Set (Buretrol)

• Review medication orders, and check for drug allergies.

• Verify compatibility of drug to be administered with infusing IV (primary solution).
• Wash hands.
• Identify client by checking armband.
• Assess infusion site for patency.
• Close clamps both above and below the volume chamber of the volume control
set (Buretrol, Soluset, Metriset).
• Open air vent on top of volume control set chamber by turning clamp.
• Insert the spike of the volume control set into IV bag, and hang bag on IV pole.
• Attach IV tubing to volume control set. Affix needleless cannula on end of tubing.
• Open upper clamp (below IV solution) to allow IV solution to partially fill volume
chamber (Buretrol), then close upper clamp.
• Open lower clamp to prime tubing and affixed cannula with primary IV fluid.
Close lower clamp.
• With alcohol swab, cleanse injection port on the top of partially filled volume
control set .
• Inject ordered medication into port.

Figure 3: Administering IV medication

through a volume control set (Buterol).
Source: Kozier et al., 1998, p. 1341.

• Mix medication and IV solution in volume control chamber by gently agitating.

• Add fluid required for dilution from IV bag by opening clamp above the volume
chamber. (Close clamp after required amount is in chamber.)
• Clearly note date, time, medication, and dosage on medication label. Place label
so it can be easily read when bag is hung.
• Program infusion pump to deliver medication at desired infusion rate.
• Open clamp below volume chamber.
• Manually adjust drip rate if not on IV pump.

Administering an IV Bolus Dose (IVP)

 • Review medication orders, and check for drug allergies.
• Verify compatibility of drug to be administered with infusing IV (primary solution).
• Wash hands.
• Identify client by checking armband.
• Assess infusion site for patency.
• With alcohol swab, cleanse Y-site injection port of primary infusion tubing
(usually port closest to infusion site).
• Stop primary infusion by pinching IV tubing closed above Y-site injection port.
• Insert needle into port, and inject medication over specified time interval.

Figure 4: Administering an IV bolus dose

(IVP).
Source: Kozier et al., 2000, p. 794.

Note: If medication is not compatible with primary IV fluids, pinch tubing and flush with
normal saline before and after administering the IV push medication.

Using an Intermittent Lock for IVP Medication

• Cleanse injection port with alcohol swab.

• Flush with normal saline to assess patency.

Figure 5: Using an intermittent lock for IVP

medication.
Source: Kozier et al., 2000, p. 79

• Insert needle into port, and inject medication over specified time interval.
• Flush with normal saline to clear line and maintain patency.
• If required, inject a diluted dose of heparin (100 units/cc) to maintain patency
according to agency policy.