Medication Administration and IV Therapy
Core concepts
Understand routes of administration (IV, IO, IM, SC, IN, PO, SL, nebulized), their onset and reliability, and the correct technique for each. Know how to establish IV and IO access, select gauge and site, calculate drip rates, and manage complications such as infiltration, extravasation, phlebitis, and air embolism. Be familiar with the "rights" of medication administration, aseptic technique, and documentation. Understand fluid resuscitation principles including isotonic crystalloids, bolus volumes, and reassessment. Know the indications and technique for intraosseous access when IV access fails.
Traps in questions
Common traps include choosing an IV route when IO is indicated for time-critical access, miscalculating drip rates, or failing to reassess after a fluid bolus. Questions may test which site or gauge is appropriate for a given situation, or the signs of infiltration versus phlebitis. Be careful with pediatric fluid boluses-smaller volumes and frequent reassessment.
Rule of thumb
In time-critical emergencies, if IV access is not rapidly obtainable, place an IO. For drip-rate calculations, use the formula: (volume × drop factor) ÷ time in minutes. Always reassess the patient and the site after administration.