1. The client/caregiver can define implanted port access devices.
   1. It is a self-sealing injection port in a plastic or metal case, placed in subcutaneous tissue below the collarbone.
   2. It has a metal base and a rubber top usually about 1 inch in diameter and a small, flexible catheter that goes to the
      bloodstream via the subclavian or jugular vein.
   3. No external parts are visible.
   4. The implanted port can be used for the same purpose as other CVADs.
2. The client/caregiver can demonstrate flushing procedure, which is usually done monthly or after each use.
   1. Wash hands well. Use masks for self and client per policy.
   2. Gather equipment (Huber needle, alcohol swabs, heparin, povidone-iodine swabs).
   3. Create a sterile field.
   4. Assess site for redness, swelling, tenderness, drainage, or bleeding.
   5. Locate port by feeling a bump on the upper chest.
   6. Clean injection site with three antimicrobial swabs by moving in a horizontal pattern, secondly a vertical pattern, and
      finally in a circular pattern moving outward. Allow to dry.
   7. Apply sterile gloves.
   8. Attach end of the sterile extension tubing to the syringe and attach the correct size Huber needle to the other end.
      Fill the tubing with saline solution.
   9. Palpate port with nondominant hand.
   10. With the dominant hand holding wings or hub, insert the Huber needle through the skin at a 90-degree angle.
   11. Check for signs of correct needle placement by aspiration of blood.
   12. If good blood returns, flush tubing with saline. Observe swelling.
   13. Stop infusion if unusual resistance is felt or swelling is noted, and notify the physician.
   14. If continuous infusion is not needed, flush with 3 ml of heparin solution.
3. The client caregiver can list precautions necessary with a port.
   1. Protect skin over port.
   2. Assess and report any signs of infection.
      1. Redness, pain, or swelling
      2. Drainage
      3. Fever
      4. Shortness of breath

References

Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.
Centers for Disease Control and Prevention. Guidelines for the prevention of catheter-related infections. MMWR 51(No.RR- 10):1-26-2002.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing . Philadelphia: Lippincott, Williams & Wilkins.
Timby, B. K. (2005). Fundamental nursing skills and concepts.Philadelphia: J. B. Lippincott Williams & Wilkins.