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24.159.1010    STANDARDS RELATED TO THE PRACTICAL NURSE'S ROLE IN INTRAVENOUS (IV) THERAPY

(1) "IV therapy" means the introduction of fluid solutions directly into the circulatory system through a venous line.

(2) "Intravenous fluids" means fluid solutions of electrolytes, nutrients, vitamins, drugs, blood and blood products.

(3) "Standard intravenous solution" means an isotonic or hypotonic solution and the following hypertonic solutions:

(a) D5.2 normal saline;

(b) D5.3 normal saline;

(c) D5.45 normal saline;

(d) D5.9 normal saline;

(e) D5 in ringers; and

(f) D5 in lactated ringers.

(4) Any of the following IV therapy tasks related to peripheral vessel IVs may be performed by an LPN:

(a) perform the initial venipuncture using a standard IV solution containing additives not otherwise prohibited by this rule, or using an intermittent infusion device, provided that the venipuncture is:

(i) made into a peripheral vessel only, and not into a peripherally inserted central catheter (PICC) line; or

(ii) made into a cannula or butterfly device;

(b) monitor the site;

(c) monitor and adjust flow rate;

(d) change dressing;

(e) hang additional standard solution;

(f) mix medication solution from a unit dose vial, except potassium, and add to IV solution or volutrol;

(g) hang medication solutions that are premixed and properly labeled by a registered nurse or pharmacist;

(h) flush intermittent infusion devices with heparin flush or normal saline solution;

(i) initiate IV pumps;

(j) administer metered dose of medication, including narcotics, by way of a patient controlled analgesia (PCA) pump;

(k) hang a PCA medication cartridge subsequent to the first, when the RN has initialized and programmed the unit;

(l) discontinue peripheral IVs except for PICC line;

(m) monitor and report the client physiological and psychological response to IV therapy; and

(n) administer injectable local anesthetics prior to venipuncture if prescribed or allowed by standing order.

(5) Any of the following tasks related to central venous lines may be performed by an LPN:

(a) change standard solutions, which may include additives not otherwise prohibited, on continuous flow, preestablished central line system; and

(b) access, draw blood, flush with a normal saline solution or a specific heparin flush solution, and change dressings.

(6) Under the direct supervision of a dialysis RN, an LPN may perform hemodialysis procedures that include:

(a) arterio-venous fistula/graft needle insertion;

(b) administration of prescribed local anesthesia as needed prior to dialysis needle insertion;

(c) accessing, drawing blood, flushing with a normal saline solution or a specific heparin flush solution, and changing dressings of hemodialysis central-venous catheters; and

(d) administration of prescribed doses of routine dialysis heparin.

History: 37-1-131, 37-8-202, MCA; IMP, 37-1-131, 37-8-202, MCA; NEW, 1997 MAR p. 1176, Eff. 4/8/97; AMD, 1998 MAR p. 2473, Eff. 9/11/98; AMD, 2000 MAR p. 954, Eff. 4/14/00; AMD, 2002 MAR p. 3149, Eff. 11/15/02; TRANS, from Commerce, & AMD, 2006 MAR p. 2035, Eff. 8/25/06.

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