If an IV solution, medicated or unmedicated, falls behind or gets ...

[londonang]

If an IV solution, medicated or unmedicated, falls behind or gets ahead of the ordered schedule, what should and shouldn't the nurse do? What are some of the concerns?
 
  What will be an ideal response?

Question 2

An IV of 1000 mL at 100 mL per hr is started at 1200 hours. At 1800 hours, 400 mL have been infused. How many mL should have been infused? How could this have been prevented?
 
  What will be an ideal response?

[aidanmbrowne]

Answer to Question 1

The nurse should not automatically readjust the flow rate. The prescriber orders the flow rate based upon the contents of the IV, patient heart, lung and renal function, diagnoses, and purpose of the IV, among other things. There are no approved catch- up formulas for any patient. The nurse is not prepared to evaluate all this. The patient condition must be assessed for symptoms of fluid or medication overload or underload. It's best to consult the prescriber promptly about ad-justments. Even abruptly slowing down a medicated IV can cause problems. Never open the IV to full flow to catch up.

Answer to Question 2

600 mL should have been infused. Monitoring IV infusion rates and volume infused frequently, at least every hour or more often, and during every visit to bedside, can prevent this type of error.