How to push IV medication through the heparin lock device

It’s your first day being on duty at the medical ward as a student nurse and you’re trying to learn everything that you could. Upon accompanying the staff nurse in her rounds, you note that she is carrying a syringe and is about to administer IV medication to a patient who has no IV. You look around the room for IV bottles, but still you can’t find any.

“Umm, excuse me ma’am. Is that for the patient?” you ask the staff nurse.

“Yes, it is,” she answers.

“But he has no IV line”

“Oh, Ms. X, this is to be given through the hep lock” she says as she motions to that tiny yellow thing sticking out from the patient’s hand.

Oh, that’s a heplock? You ask yourself since it’s your first time to see one and wonder how one gives medications through it

medication-administration-part-2-72-728Steps:

  1. Observe 10 Golden rules in the administration of the medication when introducing medication to the patient
  2. Verify doctor’s order sheet or prescription.
  3. Check medication card against the written doctor’s prescription
  4. Explain procedure to the patient (name of the medicine and action) before administration.
  5. Do hand hygiene before and after the procedure (use gloves especially for chemo drugs).
  6. Gather equipment to include/but not limit to IV tray, Normal Saline diluents or isotonic 2.5 cc syringes (2-3 pcs) as needed.
  7. Prepare medication to be administered, e.g, antibiotic, and draw it up into syringe.
  8. Fill a tuberculin syringe with Heparin solution. N.B. Heparin solution is usually prepared with 0.1 cc. Heparin plus 0.99 cc Normal Saline or isotonic solution as prescribed by theDoctor.
  9. Fill the 2.5cc syringe with isotonic solution or Normal Saline solution; 1cc each.
  10. If using Heparin Lock Device with 3-way stop cock with luer-lock, rotate the stop cock so that the line going to the patient is closed (this will prevent backflow of blood.)
  11. Remove the cover of the injection port aseptically and keep the sterility of the cover.
  12. Check the patency, open the IV line and inject NSS or isotonic solution to flush the heparin solution as prescribed by the Doctor.
  13. Close the IV line and remove saline syringe and insert medication syringe into the port. Give I.V. push 5-10 minutes for IV potent drug. For 2-3 I.V. Medications, give at least 30 minutes to 1 hour interval. After each drug administered via I.V. push, flush with 2-3 cc saline solution.
  14. Observe patient for any adverse reactions and do nursing intervention accordingly.
  15. Discard waste according to Health Care Waste Management (DOH/DENR).
  16. Document in the patient’s chart.

Notes:

  •  Some Hospital Does Not Use Heparin Anymore
  • Normal Saline can take the place of Heparin. Studies have shown the efficacy of NSS. Heparin solution can be used if normal saline or isotonic is not available and as prescribed by the M.D.

Sources:

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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