A nurse is preparing to administer a prescribed intravenous (IV) push medication through a client's peripheral intermittent IV access device (saline lock). Arrange the following steps in the correct order from first to last.
- 1Perform hand hygiene and don clean gloves.
- 2Clean the injection port with an antimicrobial swab.
- 3Aspirate for blood return and flush the catheter with 0.9% sodium chloride.
- 4Administer the prescribed medication at the recommended rate.
- 5Flush the IV catheter with 0.9% sodium chloride at the same rate as the medication.
Answer
The correct sequence is: perform hand hygiene, clean the injection port, aspirate and flush with saline to assess patency, administer the medication, and perform the final saline flush at the same rate as the medication administration.
The SAS (Saline-Administer-Saline) method is the standard protocol for administering an IV push medication through an intermittent saline lock. First, standard precautions (hand hygiene and gloves) are implemented. Next, the injection port is disinfected to prevent bloodstream infections. The nurse then checks patency by aspirating for blood and flushing with saline to ensure the line has not infiltrated. After verifying patency, the medication is administered at the prescribed rate. Finally, a second saline flush clears the medication from the tubing; crucially, this flush must be administered at the same rate as the medication to prevent rapidly bolusing the residual drug left in the extension tubing.
Step-by-Step Solution
Key Concept
Administration of an IV push medication through a peripheral intermittent lock requires the SAS (Saline-Administer-Saline) sequence to verify patency, deliver the medication safely, and maintain catheter function.