NRSGPHARMACOLO ATI Critical Care Meds 2025/2026

ATI Critical Care

Your responsibilities include:
• inserting peripheral IV catheters

• starting continuous IV infusions

• administering medications

• monitoring IV sites



Providers prescription includes:
• type of fluid

• the volume the client needs

• rate to infuse the fluid



Administering IV Fluids
• large-volume continuous IV infusions

• Large volume IV bolus

• Intermittent IV infusion

• IV Bolus medication - short lasting



IV Flow Rates
Large-volume IV bolus
• Given rapidly to replace fluid loss resulting from:

• dehydration

• shock

• hemorrhage

• burns

• trauma

• Dextrose 5% in 0.45% sodium chloride

• (D5W 0.45% NaCl)

• 250 mL over 15 min

• Monitor for: wheezing dyspnea, or other indications of fluid overload

• Use a large gauge angiocatheter or central line to allow rapid

infusion of the fluid

Calculating dosages for continuous IV infusions
• Infusion pump for continuous IV medication infusions

• use electronic pump for continuous IV medications

• Units/hr, mg/hr, mg/min, mcg/kg/min

• Titrate dosage to maintain prescribed parameters

• Check dosage with another nurse

,IV Heparin
• Anticoagulant; prevents blood clots

• Give initial IV bolus, then continuous IV infusion:

• Follows acute myocardial infarction

• Prevents additional clot formation for venous thrombosis

• Initial IV bolus: units/kg

• Continuous infusion: units/kg/hr



IV Magnesium Sulfate
• Electrolyte that activates many intra-cellular enzymes; helps regulate

skeletal muscle contractility & blood coagulation
• Acute myocardial infarction, cardiac arrest, seizures secondary yo

eclampsia, preterm labor, magnesium deficiency
• Monitor:

• cardiac & neuromuscular status

• serum Mg levels

• hypotension

• depresses cardiac function

• depressed or absent deep tendon reflexes

• respiratory depression

• IV bolus: mg/kg, or

• Continuous IV infusion: mg/hr



IV Labetadol (Trandate)
• Antihypertensive

• 3rd generation adrenergic receptor blocking agent with alpha &

nonselective beta activity
• alpha blockade results in vasodilation to decrease peripheral

resistance & lowers blood pressure
• Beta blockade decreases heart rate, myocardial contractility, &

rate of conduction through the AV node
• the vasodilation makes it effective in severe hypertension

• Severe hypertension

• Monitor:

• vital signs

• cardiac status

• hypotension

• bradycardia

• nausea

, • dizziness
• sweating
• IV bolus: mg
• Continuous IV infusion: mg/min

IV Dopamine
• Cardiac stimulant, vasopressor

• aka Intrepid is an alpha & beta adrenergic agonist

• activates beta-1 receptors in the heart & increases cardiac output

leading to increased tissue perfusion
• activates dopamine receptors in the kidneys, which dilate renal

vessels leading to increased GFR & urinary output
• Used treatment of:

• Heart failure

• cariogenic shock

• septic shock

• Continuous IV infusion: mcg/kg/hr

• Monitor:

• vital signs

• cardiac status for:

• tachycardia

• dysrhythmias

• angina pain

• MI

• High doses can cause alpha-1 activation leading to local

vasoconstriction so monitor for extravasation

Titrating Continuous IV Medication Infusions
Titrating a continuous IV medication infusion is adjusting the medication
amount in small amounts to maintain assessment findings within a
prescribed range
• Continuous client monitoring

• Dosages based on parameters

• Parameter examples:

• blood pressure

• heart rate

• cardiac output

• sedation level

• Accurate dosage calculation

• Medications:

, • dopamine
• heparin
• nitroprusside
• norepinephrine
• dobutamine
• nitroglycerin

IV Nitroprusside (aka Nipride)
• Non-nitrate vasodilator, antihypertensive

• Causes direct vasodilation of arteries & veins, rapidly reducing BP

• Used for hypertensive crisis

• effects start immediately; critical to monitor BP within prescribed

range
• Continuous IV infusion: mcg/kg/min

• Monitor:

• vital signs

• cardiac status for:

• profound hypotension

• bradycardia

• tachycardia

• ECG changes

• tinnitus

• blurred vision

• fatigue

• absent reflexes

• change in mental status (can indicate thiocyanate toxicity)



IV Nitroglycerin (Tridil)
• Organic nitrate

• Vasodilator of arteries and veins

• Results in:

• rapid reduction of blood pressure

• decrease in venous return

• decreases cardiac oxygen demand

• Useful for:

• Acute coronary syndrome

• angina

• myocardial infarction

• acute hypertensive crisis

• IV bolus: mg