University of Pennsylvania School of Nursing
Helene Fuld Pavilion for Innovative Learning
N5070 Medication Administration
Student Version – Fall 2024
MODULE: Administration of Intravenous Medications
Maintaining an intravenous therapy system traditionally has been a complex clinical skill performed
by nurses. Many institutions are conducting certification programs to prepare professional nurses to
complete venipuncture for the purpose of intravenous therapy; such an invasive measure relies on
the concepts of infection control and aseptic technique. Caring for a patient receiving intravenous
therapy has added responsibility and requires the nurse to have a comprehensive knowledge base
related to acid-base imbalances, normal electrolyte values, fluid balance, and blood chemistry
values.
*You may use additional and outside resources for this assignment. You should reference and cite
each source.
*These assignments are to be done independently and any collaboration is considered a violation of
academic integrity.
LEARNING OBJECTIVES (48 points):
1. State 3 adult patient signs/symptoms (from at least 3 different body systems) for both of the
listed fluid imbalances. (6 points) (Banasik, Chp. 24)
a. Volume excess (3 points)
Skin: Skin edema, weight gain
Cardio: bounding pulse, neck vein distention with upright position
Pulmonary: dependent portion of lungs have crackles, dyspnea, orthopnea,
pulmonary edema with frothy mucus
b. Volume deficit (3 points)
Skin: sudden weight loss, decreased skin turgor, oral mucus membrane
between check and gum becomes dry, eyeballs are soft sunken, no tears and
sweat
CNS: lightheadedness, dizziness
Cardio: decreased postural blood pressure accompanied with increased heart
rate, capillary refill time and small-vein filling time are prolonged, flat neck
veins/veins collapse with inspiration in the supine position, syncope
Renal: oliguria, if kidneys respond normally, then urine volume is small and
concentrated with quite yellow color
GI: hard stools, longitudinal furrows in the tongue
2. List the most clinically important electrolytes. (3.5 points) (Banasik, Chp.24)
The most clinically important electrolytes are ions sodium, chloride, potassium, magnesium,
bicarbonate, phosphate, and calcium.
5/2024
, 3. What are 4 things that should be considered when selecting the appropriate Vascular
Access Device (VAD)? (P&P Chapter 28) (4 points)
1. The prescribed therapy of the patient
2. The length of treatment
3. The duration the VAD remains in the place
4. Characteristics of the vasculature
5. Patient’s body weight, age, height, co-morbidities, preference for location.
4. What are the drop factors for macro and micro drips? What rates do macro and micro
drips deliver? (1 point) (P&P, Ch. 28)
Macro drips: 10 to 15 gtt/mL, and deliver rates greater than 100 mL/h
Micro drips: 60 gtt/mL, and deliver rates less than 100 mL/h
5. How often should continuous administration IV sets be changed (P & P Chapter, 28) (1
point)
The sets should be changed not more often than every 96 hours, however, should be changed at
least every 7 days.
6. Give 2 examples of how to reduce risk for administration set misconnections. (P & P,
Chapter 28) (2 points)
1. The path between the IV fluid container and the patient should be traced
2. Both the administration sets near the patients and solution container should be labeled.
7. For each complication listed below, define correlating signs/symptoms and the nursing
interventions/treatment modalities associated with each. (16 points) (P&P Chp. 28)
Complication Signs & Symptoms (Each box worth Nursing Interventions/Treatment (Each
2 points) box worth 2 points)
Phlebitis (vein Pain, redness, warmth, swelling, -Health care provider should be notified
inflammation) induration, presence of palpable -Cause should be determined (whether it is
cord along the course of vein bacterial, chemical or mechanical), and the
removal/replacement of VAD should be
considered.
Chemical phlebitis: heat should be applied,
limb is elevated, and the infusion rate
should be slowed
Mechanical phlebitis: heat is applied, limb
is elevated, monitor for 24 hours, remove
the catheter in the case of persistent signs
and symptoms
5/2024