Implanted ports

[jennyjenny8675309]

Hi

I am a new grad and just had my first interview today on a Oncology floor. Which by the way is where I really want to work. During the interview the nurse manager told me they sometimes they have sickle cell patients on the floor. She was asking "how would you handle questions". She asked if you had a sickle cell patient come up to the floor. Patient has a implanted port in the chest. There is a order for diluadid and he wants in the port. What do you do?

What is the best way to answer???

Thanks so much for the input?:redbeathe

[netglow, ASN, RN]

What did you say?

[jennyjenny8675309]

Well, that's the problem. Up until this point I was pretty sure about everything asked. I just feel that I did not take my time before I started speaking. I would check the order for the the route ordered by the doctor. Check the patients chart to see how it was administered previously. Check hospital protocol.

I am mad at myself, because looking back I really was not sure and I should have just said so.

[netglow, ASN, RN]

You just never really know what they were wanting you to say. Nothing you said is wrong. But I think they were going for the overdone scenario: is that patient a seeker wanting a rush through h/her port even though an sc patient?

[opey9519]

http://www.chemocare.com/whatis/how_is_chemotherapy_given.asp

Good info about ports (types, uses) for you...be aware, ports are not the same as IV sites for drugs- so just because a pt wants it in the port, doesn't mean the pt can have it in their port. They tend to think a needle "in" is a needle in. Not so much!

[jennyjenny8675309]

Thanks so much for the replies so far. You know she did follow up with that some times SC patients can be hard. They really know when they are supposed to get their meds. I think I missed the topic of the question. Ok thanks so much because honestly I really was not clear as if giving dilaudid through a port was such a good idea. That was what I was worried about. That maybe through an IV was safer...

I will check out the ports on the link. Thanks

[SilentfadesRPA]

You were asked :

... asked if you had a sickle cell patient come up to the floor. Patient has a implanted port in the chest. There is a order for diluadid and he wants in the port. What do you do?

And answered:

I would check the order for the the route ordered by the doctor. Check the patients chart to see how it was administered previously. Check hospital protocol.

I think your answer was quite adequte - The only area you may have wished to add was to explore the patients reason for wishing the administration this route and that this would be conveyed to his provider.

It was great that you did not just go along with the patient directives and that you expressed to look not only in his chart but in the P&P.

I wish you the best in obtaining this position.

Marc

[blondy2061h, MSN, RN]

I'm confused by how this is an issue. If the med is orders IV, the implanted port is the only logical place to give it, in my opinion. That's why the ports are placed- for reliable IV access. I certainly wouldn't slam it in. Depending on the dose, slow IV push or piggybacked in 50mls over 15 minutes.

[ChristineN, BSN, RN]

I'm confused by how this is an issue. If the med is orders IV, the implanted port is the only logical place to give it, in my opinion. That's why the ports are placed- for reliable IV access. I certainly wouldn't slam it in. Depending on the dose, slow IV push or piggybacked in 50mls over 15 minutes.

I have seen in the ER where if port pts come in and are just getting Zofran x1 or Dilaudid x 1 they will do a PIV if possible since they reason a port access for 1 med is more risk of central line infection than it's worth. However, if the pt is sickle cell and already admitted to the floor my assumption would be there is also an order for IV fluids since IV fluids helps stop the sickling process. In that case, I would definitely access since you'll be using the port for fluids as well as IV push meds.

[blondy2061h, MSN, RN]

I have seen in the ER where if port pts come in and are just getting Zofran x1 or Dilaudid x 1 they will do a PIV if possible since they reason a port access for 1 med is more risk of central line infection than it's worth. However, if the pt is sickle cell and already admitted to the floor my assumption would be there is also an order for IV fluids since IV fluids helps stop the sickling process. In that case, I would definitely access since you'll be using the port for fluids as well as IV push meds.

Yeah, I can see not using it in the ER when you're trying to street the patient quickly, but this was framed in an inpatient oncology/hematology setting. Odd question to ask in an interview, imo.

[Mulan]

Maybe, check to see if there is a doctors order to use the port, which is required in some facilities.

[jennyjenny8675309]

Thanks so much for all the answers. I do believe I was on the right track now when I answered the way I did. I think I will hear about a second interview by Monday. Crossing my fingers and I will let you know!!!

Thanks for all the good input. I love this site!!