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Preparing an Intravenous Tray

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Name: ________________________________________
Date: _________________________________________
Procedure 54-12:
Preparing an Intravenous Tray
Objective: Prepare an intravenous (IV) tray.
Equipment and Supplies: Absorbent disposable sheet; alcohol prep pads; Betadine swabs;
disposable tourniquet; IV setup: IV tubing with attached filter; IV catheter; bag of IV fluid labeled
with type and patient’s name, date, time; paper tape; syringe; port cap; disposable gloves; gauze
(2 × 2 or 4 × 4); IV setup tray; IV pole with pump
Affective Behaviors: Affective behaviors provide a professional approach to a skill that enhances
the patient encounter. These behaviors may also display sensitivity to a patient’s rights and
enhance communication. Pay close attention to these skills, which will be in bold, italicized font.
Skills Assessment Requirements
Read and familiarize yourself with the procedure. Complete each procedure within a reasonable
amount of time, with a minimum of 85% accuracy.
Documentation
Use the area below for any documentation needed to complete the procedure.
Procedure_54-1 to 55-5.indd Page 49 26/04/17 6:57 PM localadmin /206/PH03233/9780134473062_BEAMAN/BEAMAN_PEARSON_COMPREHENSIVE_MEDICAL_ASSISTING_ ...
Name: ________________________________________
Date: _________________________________________
POINT VALUE
✦ = 3–6 points
✶ = 7–9 points
GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
1. ✦ Perform hand hygiene.
2. ✦ Apply gloves.
3. ✶ Prepare IV fluid administration set:
a. Inspect the fluid bag to make
sure it contains desired fluid,
that the fluid is clear, and that
the bag is free from any leaks
and has not expired.
b. Select the correct
administration set (either mini
or macro drip) and uncoil the
tubing, being careful that the
ends of the tubing do not
become contaminated.
c. Close the flow regulator to the
fluid bag.
d. Remove the protective
covering from the port of the
fluid bag and the protective
covering from the spike of the
administration set.
e. Insert the spike of the
administration set into the port
of the fluid bag with a quick
twisting motion, being careful
not to puncture yourself.
f. While holding the fluid bag
higher than the drip chamber of
the administration set, squeeze
the drip chamber once or twice
to start the flow of the fluid.
Fill the chamber to the marker
line. If the chamber is overfilled,
quickly lower the bag below the
level of the drip chamber and
squeeze some of the fluid back
into the fluid bag.
Procedure_54-1 to 55-5.indd Page 50 26/04/17 6:57 PM localadmin /206/PH03233/9780134473062_BEAMAN/BEAMAN_PEARSON_COMPREHENSIVE_MEDICAL_ASSISTING_ ...
Name: ________________________________________
Date: _________________________________________
POINT VALUE
✦ = 3–6 points
✶ = 7–9 points
GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
g. Open the flow regulator and
allow the fluid to flush all the air
from the tubing. A trash can or
the wrapper the fluid came in
can be used for the overflow of
fluid.
h. Turn o the flow and place the
sterile cap back on the end of
the administration set (if you
had to remove it). Then place
this end nearby so it can be
easily reached by the person
ready to connect it to the IV
catheter in the patient’s arm.
4. ✦ Place the absorbent disposable
sheet on the tray.
5. ✦ Assemble equipment and supplies
on the tray in order of use.
6. ✶ If using an IV pole or pump, hang
the IV solution (bag) on the pole;
do not set it up or calculate drops
in the pump; this will be done by
the person starting the IV.
7. ✦ Notify the appropriate personnel
(RN, LVN, physician) that
the IV tray setup is ready for
administration.
8. ✦ Remove and discard gloves and
perform hand hygiene.
9. ✶ Document the procedure.
10. ✦ Clean the work area and
equipment according to OSHA
guidelines.
Procedure_54-1 to 55-5.indd Page 51 26/04/17 6:57 PM localadmin /206/PH03233/9780134473062_BEAMAN/BEAMAN_PEARSON_COMPREHENSIVE_MEDICAL_ASSISTING_ ...
Name: ________________________________________
Date: _________________________________________
POINT VALUE
✦ = 3–6 points
✶ = 7–9 points
GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
GRADING
Points Earned
Points Possible 69 69
Percent Grade (Points Earned/
Points Possible)
PASS: ❑ YES
❑ NO
❑ N/A
❑ YES
❑ NO
❑ N/A
Instructor Sign-O
Instructor: ______________________________________________ Date: _________________________
Procedure_54-1 to 55-5.indd Page 52 26/04/17 6:57 PM localadmin /206/PH03233/9780134473062_BEAMAN/BEAMAN_PEARSON_COMPREHENSIVE_MEDICAL_ASSISTING_ ...
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Preparing an Intravenous Tray

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Completed 10 December 2020

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