Nursing Component Task
Nursing procedures & clinical learning

General Nursing (RGN)

ADMINISTRATION OF INTRAVENOUS MEDICATION (AMPOULE/VIAL RECONSTITUTION)

This procedure covers reconstitution of a prescribed injectable medication from an ampoule or vial and administration through suitable IV access when that route and method are authorised. Accurate diluent selection, aseptic preparation, concentration checks, safe IV access and close observation are essential.

Purpose

  • Prepare a stable, accurate concentration of prescribed injectable medication
  • Administer medication through an appropriate IV access using the prescribed method
  • Detect local or systemic complications early

Indications

  • A prescribed injectable medication supplied as an ampoule or powder in a vial
  • Manufacturer or pharmacy instructions specify reconstitution before administration
  • The patient has suitable IV access and the route is authorised

Equipment

  • Medication ampoule or vial and authorised treatment chart
  • Correct sterile diluent and reconstitution device
  • Sterile syringe and needles or needleless transfer device
  • Alcohol or approved antiseptic swabs and sterile gauze
  • Gloves and PPE according to risk assessment
  • Receiver, sharps container, waste receptacle and hand hygiene supplies
  • Compatible IV access supplies and prescribed flush when required

Preparation

  • Check the prescription, patient, medication, dose, route, expiry, allergies, diluent, concentration and reconstitution instructions.
  • Check compatibility, storage conditions, required final volume and beyond-use time before preparing the medication.
  • Prepare in a clean designated area using aseptic non-touch technique and explain the procedure to the patient.

Procedure steps

  • Perform hand hygiene and identify the patient using approved identifiers.
  • Inspect the ampoule or vial, diluent and equipment; reject any damaged, expired or compromised item.
  • Use safe ampoule-opening technique or disinfect the vial stopper and allow it to dry.
  • Draw up the correct diluent, add it to the vial when required and dissolve the medication using the prescribed gentle method.
  • Inspect the reconstituted solution for the expected appearance, particles, precipitate, colour and volume.
  • Draw up the prescribed dose using a new sterile syringe and suitable needle or transfer device; remove air safely.
  • Assess IV access for patency and site complications, disinfect the access port and allow it to dry.
  • Administer at the prescribed rate or connect to the compatible infusion system; observe the patient and site throughout.
  • Stop administration and seek urgent help for significant pain, swelling, resistance, rash, wheeze, hypotension or deterioration.
  • Dispose of sharps and materials safely, perform hand hygiene, reassess the patient and document the preparation and administration.

Precautions

  • Do not administer a solution that is cloudy, discoloured, precipitated, contaminated or outside its permitted use time.
  • Do not substitute a diluent, change the final concentration or mix medications without authorised compatibility guidance.
  • Do not force a syringe against resistance or continue through a painful, swollen or leaking IV site.
  • Use a second qualified checker when required for high-alert medicines by facility policy.

Aftercare

  • Monitor the patient for immediate and delayed effects and maintain IV access as prescribed.
  • Store or discard any remaining preparation according to the product and facility policy; do not retain an unlabelled syringe.

Nursing considerations

  • Follow the manufacturer's instructions, pharmacy guidance and facility IV medication policy.
  • Escalate any discrepancy rather than making an independent alteration to the prescribed preparation.

Possible complications

  • Wrong concentration or dose
  • Incompatibility, precipitation or contamination
  • Infiltration, extravasation or phlebitis
  • Rapid adverse effect or anaphylaxis

Patient education

  • Explain that the medication may act quickly and ask the patient to report pain, burning, itching, rash, breathlessness or dizziness immediately.
  • Reassure the patient while maintaining privacy and observing the injection site.

Documentation

  • Record medication, diluent, dose, final concentration, route, time, site, rate and patient response.
  • Record batch or lot details and expiry of the reconstituted product when required, plus any reaction or escalation.

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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