Comprehensive Nursing Pharmacology Q 297
Kent, a new staff nurse asks her preceptor nurse how to obtain a blood sample from a patient with a portacath device. The preceptor nurse teaches the new staff nurse:
A. The sample will be withdrawn into a syringe attached to the Portacath needle and then placed into a vacutainer.
B. Portacath devices are not used to obtain blood samples because of the risk of clot formation.
C. The vacutainer will be attached to the Portacath needle to obtain a direct sample.
D. Any needle and syringe may be utilized to obtain the sample.
Correct Answer: A. The sample will be withdrawn into a syringe attached to the Portacath needle and then placed into a vacutainer.
A special port-a-cath needle is used to access the port-a-cath device. A syringe is attached and the sample is obtained. One of the primary reasons for the insertion of a Portacath device is the need for frequent or long-term blood sampling. A Portacath is a small chamber or reservoir that sits under the skin at the end of the central line. The other end of the line sits in a large vein close to the heart. The client may feel the chamber of the Portacath, but unless he is very thin he can’t usually see it.
Option B: The line is flushed regularly with heparin (an anti-clotting drug) or saltwater (saline) to clean the line and prevent clotting. Once a port is cleared for use, a patient may receive intravenous therapy through it for the course of his/her treatment. An adult portal chamber can take about 2,000 punctures on average, which may last a patient several years.
Option C: A vacutainer will exert too much suction on the central line resulting in the collapse of the line. One can draw blood from a CVC using the discard method with direct Vacutainer connection or a syringe or using the push-pull method with a syringe. A vacutainer is a blood collection tube (sterile glass or plastic tube) used to collect blood samples for laboratory testing. These tubes have a closure that is evacuated to create a vacuum inside the tube thereby enabling a predetermined amount of blood to be withdrawn.
Option D: Only special Portacath needles should be used to access the Portacath device. A port can be single or double lumen. Single lumen ports are most common and typically sufficient for patients requiring scheduled intravenous therapy. However, having a double lumen port is advantageous for patients who often receive multiple intravenous therapies at once. If two intravenous agents aren’t compatible in the same line, you can infuse both simultaneously in different port lumens without complication. The double lumen port also allows a concurrent infusion of medication, chemotherapy, blood products, or parenteral nutrition. It is also beneficial for drawing labs without interruption of an infusion.