Implanted ports for Chemotherapy

Nurses General Nursing

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Hello, I have a question. As a student nurse in oncology right now I find myself intrigued about the implanted ports. My question is this what exactly are oncology nurses assessing for. From the research, I have found drug side effects, such as alopecia, n/v, fatigue and so on. But I am more interested in what one would see as far as adverse effects. What's is the nurse watching for when they medication is being infused thru the pump to the port? Is it only extravasation, and I don't say that lightly? I, also, understand assessing for patency but that too is to decrease the risk for extravasation, and occlusion, right?

Specializes in Oncology (OCN).

I'm an oncology RN. I'm currently on medical disability and have a port myself (not for chemo, but for monthly ketamine infusions for CRPS, so I have have experience with ports both as a nurse and a patient. Some of the things that are important to watch for other than s/s of extravasation (although that's clearly a big one, especially with vesicants!) are s/s of infection (fever, redness, swelling, exudate at needle site, etc.). Like with any other CVC, because the port catheter ends in the superior vena cava any infection in the line can quickly become serious. If you think about anatomy, the superior vena cava goes into the right atrium of the heart.

Also look for s/s of skin breakdown at the dressing site. I personally have issues with tegaderm dressings and have noticed many oncology patients also tend to be sensitive to adhesives. Skin breakdown in an already immuno-compromised (low WBCs, low platelets, etc. secondary to chemo) patient can lead to serious complications like infection or bleeding.

I hope you are enjoying your time in oncology. It's truly a fascinating field. I'm really looking forward to getting back to it soon!

Thank you so much

I'm an oncology RN. I'm currently on medical disability and have a port myself (not for chemo, but for monthly ketamine infusions for CRPS, so I have have experience with ports both as a nurse and a patient. Some of the things that are important to watch for other than s/s of extravasation (although that's clearly a big one, especially with vesicants!) are s/s of infection (fever, redness, swelling, exudate at needle site, etc.). Like with any other CVC, because the port catheter ends in the superior vena cava any infection in the line can quickly become serious. If you think about anatomy, the superior vena cava goes into the right atrium of the heart.

Also look for s/s of skin breakdown at the dressing site. I personally have issues with tegaderm dressings and have noticed many oncology patients also tend to be sensitive to adhesives. Skin breakdown in an already immuno-compromised (low WBCs, low platelets, etc. secondary to chemo) patient can lead to serious complications like infection or bleeding.

I hope you are enjoying your time in oncology. It's truly a fascinating field. I'm really looking forward to getting back to it soon!

Just replying to say that I have CRPS too. It sucks big time. I'm glad you found something that helps(I'm assuming). It's rare to meet a another with the same diagnosis.

Specializes in Oncology (OCN).
Just replying to say that I have CRPS too. It sucks big time. I'm glad you found something that helps(I'm assuming). It's rare to meet a another with the same diagnosis.

Hi BeckyESRN! CRPS does indeed suck! I've been doing ketamine infusions now for just shy of 4 years. That coupled with Aqua Therapy, dietary changes (anti-inflammatory diet), regular exercise balanced with periods of rest, regular sleep, etc. has really given me my life back. It's been a very slow process with several setbacks and I'm still not all the way there yet, I have a way to go. But I am currently to the point where I am enrolled (and about halfway through) a Refresher Course to reactivate my RN license with a goal of returning to nursing on a part-time basis this next year. It has been a long journey to get here but I have learned so, so much!

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