Intravenous injections are used to provide rapid onset for a medication because the medication is directly injected into the circulatory system (IV push [IVP]). IVs can be placed in the cephalic or cubital vein of the arm or the dorsal vein of the hand. However, cubital veins should be avoided except in emergency situation because cubital veins are used for withdrawing blood specimens for laboratory testing. Start an IV at the hand and then work toward the cubital vein.

IV injections use a 21- to 23-gauge needle that are 1 to 1.5 inches in length. Use the larger bore for viscous (thicker) drugs. IV lines are inserted with a butterfly needle or with an angiocatheter that ranges from 14 gauge for whole blood or fractions of blood to 23 gauge for rapid infusion. Medication may be administered directly into the vein with a syringe, into an intermittent catheter inserted into the patient's vein, or injected into intravenous fluids such as 5% Dextrose in Water (D5W) and delivered as an intravenous drip called a piggy back.

Here's how to administer medication IV:

• Check the prescriber's medication order.

• Wash hands and then put on clean gloves.

• Properly identify the patient.

• Cleanse the area of the site in a circular motion using alcohol or betadine as per the agency guidelines.

• Apply a tourniquet above the site.

• Insert the butterfly or catheter into the vein until blood returns through the butterfly or catheter.

• Remove the tourniquet.

• Stabilize the needle or catheter.

• Dress the site according to your healthcare agency's policy.

• Monitor the flow rate of the IV fluid, distal pulses, skin color (redness [infection]), skin temperature, insertion site for infiltration (swelling), and side effects of the medication since the action of the medication occurs rapidly.

• Follow policy agency policy regarding adding medications to the fluid in the bottle or bag, piggy back technique, and intravenous push.

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