Central Mindanao University
College of Nursing
FUNDAMENTALS OF NURSING PRACTICE, RLE
Procedure Checklist
Name of Student:
Clinical Instructor:
Albumin IV Piggyback Continuous Administration
A. Direction: Write your answers on the space provided.
Assessments:
Possible Nursing Diagnoses:
1.
2.
Materials:
B. Directions: Provide your assessment findings/rationale on the box. You are rated based on the
performance rubrics.
PROCEDURE RATIONALE
1. Verify the practitioner's order. Know
why the client is receiving the
medication.
2. Verify the dose and check if it is in
the recommended rate of infusion
and storage according to
manufacturer’s manual.
3. Obtain informed consent from the
client or significant other.
4. Know the actions, adverse effects,
side effects and nursing
responsibilities related to the drug.
Assess the client for history of
allergies especially on blood product.
5. Perform Hand-hygiene
6. Prepare and gather supplies. Perform
assessment check on supplies and
infusion solution.
7. Compare doctor’s orders with the
medication ticket and the
medication ticket with the
medication. Check if the order
whether Albumin is 4% or 20%
solution.
8. Check the expiration date and
integrity of the solution.
9. Perform the standing “3 checks “of
the drug together with the
medication ticket.
∙ When it is taken from the medication
cart
∙ Before preparing the medication
∙ After preparing medication
MEDICATION ADMINISTRATION
Central Mindanao University
College of Nursing
FUNDAMENTALS OF NURSING PRACTICE, RLE
Procedure Checklist
PROCEDURE RATIONALE
10. Transport the medication using a
tray and the necessary supplies to the
patient’s bedside.
11. Identify the patient.
12. Introduce yourself, and identify the
patient. Explain the procedure and
the actions of the medication. Take
baseline vital signs.
14. Provide client’s privacy.
15. Wash hands, don gloves.
15. Assess IV site for abnormalities,
infections, and dislodgment.
16. Open the seal of the IV solution
bottle. Check for gross contamination
17. Open a new set of IV line aseptically.
Do not let IV line touch the ground
surface area. Close the IV line
clamp.
18. Spike the IV solution bottle and
hang in the IV pole stand. Prime the
tubing, fill the drip chamber half
full, and continuously prime the iv
line with solution. Remove air
bubbles if present. Note: always put
and IV tag/label in every piggyback
solution.
19. Disinfect the Main IV line Y-port.
Remove protective cap of the Albumin iv
line and connect to main IV line y-port.
20. Lower the main IV line bottle if
possible. Slowly open the piggyback IV
line clamp and regulate to the desired
infusion rate according to doctor’s order.
21. Remove disposable gloves to
appropriate container.
22. Document the administration of the
medication immediately after
administration. Document the volume of
fuid administered on the intake and
output record, if necessary.
23. Evaluate the patient’s response to the
medication within an appropriate time
frame. Monitor IV site at periodic
intervals.
Reference: (Taylor, Lillis, & P., 2011)
MEDICATION ADMINISTRATION
Central Mindanao University
College of Nursing
FUNDAMENTALS OF NURSING PRACTICE,
RLE Procedure Checklist
C. Write medical terms and abbreviations related to this procedure. Provide meaning for each.
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