Question

1. IVIG infusion: the ordered dose is 2 gm/kg/dose. (IVIG concentration is 2 gm/10 ml 0.9 NS). The nurse runs the IVIG over 6 hours, discuss the drug class, side effects, patient and family education and nursing considerations
   1. Calculate the correct dose for this patient: ____________
   2. The first ½ hour: run infusion at ¼ rate for 30 minutes – what is that rate? ___________/hr
   3. The second ½ hour: run infusion at ½ rate for 30 minutes – what is that rate? ___________/hr
   4. If the infusion is tolerated increase to the rate of 2 ml/kg/hour until complete. What is that rate: ______ / hour

Answer 1

1. Drug class- intravenous immunoglobulin.

2. Side effects--a) headache

b) Flushing

C)chills.

d)myalgia

e) wheezing

f) tachycardia

g)lower back pain

h)nausea

i) hypotension

J) migraine.

Patient teaching-a) advice patient to take sufficient amount of fluid daily.

b) advice patient to check weight everyday.

c) inform patient about post information reaction like headache nausea ,low grade fever.

d) tell the patient if any adverse effect like burning, redness, local itching appears immediately inform it to doctor.

Family teaching--a) tell the family member immunoglobulin should be given at room temperature.

b) never put product into microwave for warming.

c) advice the family member to monitor the patient for taking sufficient amount of fluid.

d) inform the family member about the adverse effect.

e) information should be given to family member about new modalities of treatment ,insurance issues.

Nurses responsibility-

1. Assess the immunoglobulins product order is appropriate for the patient.

2. Check the dose, expiry date ,site before infusion.

3. The first dose should be administered in a controlled setting ,where emergency equipment and treatment is readily available.

4. Assess product integrity. If the protective seals are not intact, dispensing pharmacy should be notified immediately and the product should not be given.

5. Assess product temperature. the immunoglobulin should be at room temperature before the infusion.

6. Assess Level of patients understanding of therapy.

7. Assess the patient General Health and hydration status .it is important to document and inform the prescriber of any new health problems which have arisen since the last infusion and /or any new medication the patient is taking as these may have an impact on prescribed therapy.

8. Assess for any weight loss or gain. immunoglobulin replacement therapy is prescribed based on weight.

9.Assess heart rate and respiratory rate .patient with congestive heart failure or who are at risk of fluid overload should be assessed carefully before beginning the infusion.

10. Assess for fever prior to the start of infusion.

11. Assess the need for premedication.

12. Assess the need for localized anaesthesia and obtain an order as necessary.

13. Assess need for laboratory blood Work to start up infusion.

14.Assess preparedness for emergency situation. Emergency equipments should be readily available during the infusion.