_____ Normal Saline or Dextrose 5%/water (circle one)_____ cc minibag
_____ alcohol wipes
_____ antibacterial soap
Prepare a clean work area.
Wash your hands (see Handwashing section for more information).
Check medication vial to make sure it is the correct medication and strength. Also check to be certain it has not expired.
Flip off the plastic protective cap of the medication vial and the sterile water for injection vials.
Wipe the top of the vials with an alcohol wipe. Use one wipe per each vial. Allow vials to dry.
Check minibag to make sure it is the correct fluid and volume.
Wipe the injection cap of the administration port on the minibag with a new alcohol wipe. Allow to dry. Set aside on clean work area.
Remove cap from syringe and attach needle to syringe.
Pull the syringe plunger back to _____ cc.
Remove needle cap and set it on clean work area for later use. Insert needle into center of rubber stopper of sterile water for injection vile.Invert the vial with the needle still inserted. Inject the air into the vial. Be sure that the tip of the needle is in solution and draw back to _____ cc. Be careful not to draw up air. Withdraw the needle from the vial.
Insert the needle into center of rubber stopper of medication vial. Inject all the sterile water into the vial. Withdraw needle from the vial. Recap needle and set syringe on clean work area for later use.
Shake the vial well until all medication is dissolved.
Repeat steps 9-11 for the medication vial. Draw up entire contents of medication vial. Withdraw the needle from the vial.
Insert the needle into the injection cap of the administration port on your minibag. Inject all the medication into the minibag. Withdraw the needle from the injection cap. Discard needle/syringe in needle container.
Shake the minibag well to mix the medication.
Use prepared minibag within _____ hours since potency may decrease significantly over this period.
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