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A client has a medi-port for chemotherapy administration. The nurse has an order to access the medi-port for a blood draw and the administration of normal saline at \(125 \mathrm{~mL} / \mathrm{hr}\). The nurse will plan on obtaining which of the following to access the device? A. A 20-gauge 1.5-inch Huber needle B. A 20-gauge 1.5-inch jelco C. A butterfly needle D. A needleless syringe system

Short Answer

Expert verified
A. A 20-gauge 1.5-inch Huber needle

Step by step solution

01

Understanding Medi-Port Access

A medi-port, or implanted port, is a type of central venous catheter (CVC) that requires a special non-coring needle for access. This type of needle is often referred to as a Huber needle, which is designed to access these ports without creating coring, which could lead to port damage or cause a piece of the silicone septum to break off.
02

Identifying the Correct Equipment

From the options given, the correct choice for accessing a medi-port for chemotherapy is a Huber needle. This needle is specifically designed for accessing the silicone septum of the medi-port repeatedly without causing damage.
03

Elimination of Incorrect Options

Eliminate options B, C, and D as they are inappropriate for accessing a medi-port. A Jelco needle is generally used for peripheral IV insertions. A butterfly needle is used for short-term access of a vein for phlebotomy. A needleless syringe system cannot access a medi-port without a compatible needle or adaptor.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Medi-Port Access
Medi-port access is employed when patients require frequent medication administration, like chemotherapy, or regular blood draws. A medi-port, also known as an implanted port or port-a-cath, is a type of central venous catheter (CVC) that's surgically placed under the skin, usually in the upper chest area. It comprises a reservoir connected to a catheter which directly enters a central vein.

The prime benefit of using a medi-port is the comfort it provides to patients, as it does away with the need for multiple needle sticks for medication administration or blood sampling. This is crucial for patients undergoing rigorous treatments such as chemotherapy, where veins can become fragile over time. To access the medi-port, one needs a special type of needle to avoid damaging the port and causing potential complications.

The procedure to access a medi-port includes using an antiseptic to cleanse the skin over the port and then inserting the non-coring needle, usually a Huber needle, through the skin and into the port's septum to either draw blood or administer therapy.
Huber Needle
A Huber needle is critical to the safe and effective use of a medi-port. This needle is uniquely designed with a side opening to enter the port without dislodging any of the silicone that forms the port's septum—a situation called 'coring'.

The Huber needle is often identifiable by its right-angle design, allowing it to lay flat against the patient's skin after insertion. This unique shape also ensures that the needle does not displace even after long periods of attachment, providing stability during the administration of medications like chemotherapy.

When choosing a Huber needle, one must pay attention to its gauge and length. The size of the needle used depends on the type of medication being administered and the specific attributes of the patient's medi-port. For instance, the 20-gauge 1.5-inch needle mentioned in the exercise is often chosen for its balance between optimal flow rates and minimized patient discomfort.
Central Venous Catheter
A central venous catheter, or CVC, is crucial for providing medications, nutrition, or collecting blood samples directly from the central venous system. It's a long, thin, flexible tube that's inserted through a vein and threaded towards the heart, ensuring medication is delivered to the bloodstream quickly.

There are different types of CVCs, including tunneled catheters, non-tunneled catheters, peripherally inserted central catheters (PICCs), and implanted ports like medi-ports. They are chosen based on the length of time they will be needed and the type of treatment the patient requires. Central venous catheters are essential in treatments requiring vascular access over a prolonged period, and their maintenance involves rigorous protocols to prevent infections and ensure proper functioning.
Chemotherapy Administration
Chemotherapy administration through a medi-port requires stringent protocols. Before administering chemotherapy, healthcare providers must verify the correct placement of the medi-port and ensure that it is functioning properly. A flush, usually saline or heparin, is often used to confirm patency before the chemotherapy is introduced.

The choice of equipment and technique is paramount to avoid complications. For instance, using a non-coring Huber needle for access and setting the infusion rate appropriately, as specified in the exercise, to 125 mL/hr for normal saline, ensure the medication is delivered at a therapeutic rate while minimizing the risk of tissue damage. After chemotherapy, protocols for flushing, needle removal, and port care must be meticulously followed to reduce the risk of infection and maintain port integrity over time.

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