A nurse is caring for a client who has an implanted port that needs to be assessed for an infusion

1. A nurse is caring for a client who requires long term central venous access and is anavid swimmer. Which of the following central venous access devices is the best choicefor this client?A. A tunneled central catheterB. An implanted portC. A nontunneled percutaneous central catheterD. A peripherally inserted central catheterB. An implanted portBecause the entire device lies beneath the skin, the client can be immersed in waterwhen the device is not in use without any increased risk for infection. This is the bestchoice for clients who wish to continue aquatic activities.
  1. Tabatabaie O, Kasumova GG, Eskander MF, Critchlow JF, Tawa NE, Tseng JF (2017) Totally implantable venous access devices: a review of complications and management strategies. Am J Clin Oncol 40:94–105

    Article  PubMed  Google Scholar 

  2. Nakamura T, Sasaki J, Asari Y, Sato T, Torii S, Watanabe M (2017) Complications after implantation of subcutaneous central venous ports (PowerPort). Ann Med Surg (Lond) 17:1–6

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hamilton HC, Foxcroft DR (2007) Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring long-term intravenous therapy. Cochrane Database Syst Rev 3:Cd004084

  4. Simpson KR, Hovsepian DM, Picus D (1997) Interventional radiologic placement of chest wall ports: results and complications in 161 consecutive placements. J Vasc Interv Radiol 8:189–195

    Article  CAS  PubMed  Google Scholar 

  5. Ballarini C, Intra M, Pisani Ceretti A et al (1999) Complications of subcutaneous infusion port in the general oncology population. Oncology 56:97–102

    Article  CAS  PubMed  Google Scholar 

  6. Denys BG, Uretsky BF, Reddy PS (1993) Ultrasound-assisted cannulation of the internal jugular vein. A prospective comparison to the external landmark-guided technique. Circulation 87:1557–1562

    Article  CAS  PubMed  Google Scholar 

  7. Kim DH, Ryu DY, Jung HJ, Lee SS (2019) Evaluation of complications of totally implantable central venous port system insertion. Exp Ther Med 17:20132018

    Google Scholar 

  8. Skelton WP 4th, Franke AJ, Welniak S et al (2019) Investigation of complications following port insertion in a cancer patient population: a retrospective analysis. Clin Med Insights Oncol 24:13

  9. Yildizeli B, Laçin T, Batirel HF, Yüksel M (2004) Complications and management of long-term central venous access catheters and ports. J Vasc Access 5:174–178

    Article  CAS  PubMed  Google Scholar 

  10. Balestreri L, De Cicco M, Matovic M, Coran F, Morassut S (1998) Totally implantable central venous access ports for long-term chemotherapy. A prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 9:767–773

  11. Balestreri L, De Cicco M, Matovic M, Coran F, Morassut S (1995) Central venous catheter-related thrombosis in clinically asymptomatic oncologic patients: a phlebographic study. Eur J Radiol 20:108–111

    Article  CAS  PubMed  Google Scholar 

  12. Walser EM (2012) Venous access ports: indications, implantation technique, follow-up, and complications. Cardiovasc Intervent Radiol 35:751–764

    Article  PubMed  Google Scholar 

  13. Keulers AR, Kiesow L, Mahnken AH (2018) Port implantation in patients with severe thrombocytopenia is safe with interventional radiology. Cardiovasc Intervent Radiol 41:80–86

    Article  PubMed  Google Scholar 

  14. Teichgräber UK, Pfitzmann R, Hofmann HA (2011) Central venous port systems as an integral part of chemotherapy. Dtsch Arztebl Int 108:147–153 quiz 154

  15. Kakkos A, Bresson L, Hudry D et al (2017) Complication-related removal of totally implantable venous access port systems: does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients. Eur J Surg Oncol 43:689–695

    Article  CAS  PubMed  Google Scholar 

  16. Wall C, Moore J, Thachil J (2016) Catheter-related thrombosis: a practical approach. J Intensive Care Soc 17:160–167

    Article  PubMed  Google Scholar 

  17. Yousaf M, Malak SF (2008) Left atrial drainage of a persistent left superior vena cava. Radiol Case Rep 3:225

    Article  PubMed  Google Scholar 

  18. Metzler B, Hillebrand H, Eulenbruch HP, Dierkesmann R, Hust MH (2002) Persistent left superior vena cava with right-left shunt into the left atrium. Dtsch Med Wochenschr 127:83–86

    Article  CAS  Google Scholar 

  19. Shields LB, Hunsaker DM, Hunsaker JC 3rd (2003) Iatrogenic catheter-related cardiac tamponade: a case report of fatal hydropericardium following subcutaneous implantation of a chemotherapeutic injection port. J Forensic Sci 48:414–418

    Article  PubMed  Google Scholar 

  20. Guilbert MC, Elkouri S, Bracco D et al (2008) Arterial trauma during central venous catheter insertion: case series, review and proposed algorithm. J Vasc Surg 48:918–925 discussion 925

    Article  PubMed  Google Scholar 

  21. Keum DY, Kim JB, Chae MC (2013) Safety of a totally implantable central venous port system with percutaneous subclavian vein access. Korean J Thorac Cardiovasc Surg 46:202–207

    Article  PubMed  PubMed Central  Google Scholar 

  22. Zoltowska D, Kalavakunta J (2018) A port-a-cath in aorta. Clin Case Rep 6:957–958

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lalu MM, Fayad A, Ahmed O et al (2015) Ultrasound-guided subclavian vein catheterization: a systematic review and meta-analysis. Crit Care Med 43:1498–1507

    Article  PubMed  Google Scholar 

  24. Byon HJ, Lee GW, Lee JH et al (2013) Comparison between ultrasound-guided supraclavicular and infraclavicular approaches for subclavian venous catheterization in children—a randomized trial. Br J Anaesth 111:788–792

    Article  PubMed  Google Scholar 

  25. Mussa FF, Towfigh S, Rowe VL, Major K, Hood DB, Weaver FA (2006) Current trends in the management of iatrogenic cervical carotid artery injuries. Vasc Endovascular Surg 40:354–361

    Article  PubMed  Google Scholar 

  26. Denys BG, Uretsky BF, Reddy PS, Ruffner RJ, Sandhu JS, Breishlatt WM (1991) An ultrasound method for safe and rapid central venous access. N Engl J Med 324:566

  27. Gilbert TB, Seneff MG, Becker RB (1995) Facilitation of internal jugular venous cannulation using an audio-guided Doppler ultrasound vascular access device: results from a prospective, dual-center, randomized, crossover clinical study. Crit Care Med 23:60–65

    Article  CAS  PubMed  Google Scholar 

  28. Hayashi H, Amano M (2002) Does ultrasound imaging before puncture facilitate internal jugular vein cannulation? Prospective randomized comparison with landmark-guided puncture in ventilated patients. J Cardiothorac Vasc Anesth 16:572–575

    Article  PubMed  Google Scholar 

  29. Teichgraber UK, Nibbe L, Gebauer B, Wagner HJ (2003) Inadvertent puncture of the thoracic duct during attempted central venous catheter placement. Cardiovasc Intervent Radiol 26:569–571

  30. Májek M, Malatinský J, Kadlic T (1977) Inadvertent thoracic duct catheterization during transjugular central venous cannulation. A case report. Acta Anaesthesiol Scand 21:320–323

    Article  PubMed  Google Scholar 

  31. Biffi R, Pozzi S, Cenciarelli S, Zambelli M, Andreoni B (2001) Treatment of pneumothorax as a complication of long-term central venous port placement in oncology patients. An observational study. J Vasc Access 2:129–136

    Article  CAS  PubMed  Google Scholar 

  32. McGee DC, Gould MK (2003) Preventing complications of central venous catheterization. N Engl J Med 348:1123–1133

    Article  PubMed  Google Scholar 

  33. Sofue K, Arai Y, Takeuchi Y, Sugimura K (2013) Flow confirmation study for central venous port in oncologic outpatient undergoing chemotherapy: evaluation of suspected system-related mechanical complications. Eur J Radiol 82:e691–e696

    Article  PubMed  Google Scholar 

  34. Oz K, Demirhan R, Onan B, Sancakli I (2009) Pulmonary artery pseudoaneurysm after a vascular access port catheter implantation. Ann Thorac Surg 87:295–297

    Article  PubMed  Google Scholar 

  35. Gowda MR, Gowda RM, Khan IA et al (2004) Positional ventricular tachycardia from a fractured mediport catheter with right ventricular migration—a case report. Angiology 55:557–560

    Article  PubMed  Google Scholar 

  36. Gebauer B, Teichgräber UK, Podrabsky P, Werk M, Hänninen EL, Felix R (2007) Radiological interventions for correction of central venous port catheter migrations. Cardiovasc Intervent Radiol 30:216–221

    Article  PubMed  Google Scholar 

  37. Tabatabaie O, Kasumova GG, Kent TS et al (2017) Upper extremity deep venous thrombosis after port insertion: what are the risk factors? Surgery 162:437–444

    Article  PubMed  Google Scholar 

  38. Daeihagh P, Jordan J, Chen J, Rocco M (2000) Efficacy of tissue plasminogen activator administration on patency of hemodialysis access catheters. Am J Kidney Dis 36:75–79

    Article  CAS  PubMed  Google Scholar 

  39. Teichgräber UK, Kausche S, Nagel SN, Gebauer B (2011) Outcome analysis in 3,160 implantations of radiologically guided placements of totally implantable central venous port systems. Eur Radiol 21:1224–1232

    Article  PubMed  Google Scholar 

  40. Chang L, Tsai JS, Huang SJ, Shih CC (2003) Evaluation of infectious complications of the implantable venous access system in a general oncologic population. Am J Infect Control 31:34–39

    Article  PubMed  Google Scholar 

  41. Shim J, Seo T, Song M et al (2014) Incidence and risk factors of infectious complications related to implantable venous-access ports. Korean J Radiol 15:494–500

    Article  PubMed  PubMed Central  Google Scholar 

  42. Bouza E, Burillo A, Muñoz P (2002) Catheter-related infections: diagnosis and intravascular treatment. Clin Microbiol Infect 8:265–274

    Article  CAS  PubMed  Google Scholar 

  43. O'Grady NP, Alexander M, Burns LA et al (2011) Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 52:e162–e193

    Article  PubMed  PubMed Central  Google Scholar 

  44. Fätkenheuer G, Buchheidt D, Cornely OA et al (2003) Central venous catheter (CVC)-related infections in neutropenic patients—guidelines of the infectious diseases working party (AGIHO) of the german society of hematology and oncology (DGHO). Ann Hematol 82(Suppl 2):S149–S157

  45. Yoshida J, Ishimaru T, Kikuchi T, Matsubara N, Asano I (2011) Association between risk of bloodstream infection and duration of use of totally implantable access ports and central lines: a 24-month study. Am J Infect Control 39:e39–e43

    Article  PubMed  Google Scholar 

  46. Leonidou L, Gogos CA (2010) Catheter-related bloodstream infections: catheter management according to pathogen. Int J Antimicrob Agents 36(Suppl 2):S26–S32

    Article  CAS  PubMed  Google Scholar 

  47. Gordy S, Rowell S (2013) Vascular air embolism. Int J Crit Illn Inj Sci 3:73–76

    Article  PubMed  PubMed Central  Google Scholar 

  48. Tsutsumi S, Fukasawa T, Fujii T et al (2012) Central venous port system-related complications in outpatient chemotherapy for colorectal cancer. Hepatogastroenterology 59:1079–1080

    CAS  PubMed  Google Scholar 

  49. Vaughan JG, Cauthen AB, Allen A, Dale P (2017) Evaluation of cardiopulmonary complication rates after port insertion: is a postoperative X-ray needed? Am Surg 83:778–779

  50. Thomopoulos T, Meyer J, Staszewicz W et al (2014) Routine chest X-ray is not mandatory after fluoroscopy-guided totally implantable venous access device insertion. Ann Vasc Surg 28:345–350

    Article  PubMed  Google Scholar 


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