NCLEX-PN

○​ Withdraw the needle, apply pressure, and bandage. For IV push with an existing line: ○​ Ensure medication compatibility. ○​ Don gloves. ○​ Close the flow clamp or pinch the tubing above the injection port. ○​ Prep the port with alcohol, inject the medication slowly, and readjust the flow rate. Intravenous Piggyback or Secondary Line Administration ●​ Ensure medication compatibility. ●​ Hang the secondary IV set (piggyback). ●​ Clean the injection port on the primary line with alcohol. ●​ Insert the secondary set into the primary IV tubing's injection port. Nurses bear legal and ethical responsibilities for ensuring the accurate and comprehensive administration, observation, and documentation of medications. In healthcare settings, various methods are employed to secure controlled substances, such as double-locked cabinets or advanced barcoded entry systems. When utilizing the traditional double-locked narcotics cabinet , nurses must conduct an inventory check at the start of their shift, comparing it with the documented count from the prior shift. Any disparities are promptly investigated, addressing and rectifying any simple oversights or mathematical errors. In cases where the narcotics count cannot be rectified, the facility's policies and procedures dictate that a report must be filed. Occasionally, inconsistent narcotics counts may result from illegal drug diversion. In contrast, facilities employing a barcoded entry system for narcotics and controlled substances automatically process and record access by nurses. Each nurse's identification is validated before they can access these medications. However, in scenarios where automated systems are not in use, a designated nurse retains " narcotic keys ." If another nurse needs to administer controlled substances, they must enter the narcotics cabinet accompanied by the nurse holding the keys. Most facilities have a Pyxis or Omnicell to store medication. Removal of the medication requires a nurse to sign in or use a fingerprint to access these automated medication dispensing systems. These systems enhance medication security and streamline the administration process, ensuring that ●​ Adjust the primary IV to run only the piggyback medication. ●​ Remove the secondary set when the medication is administered. Documenting Medication Administration Across All Routes

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