Lesson 14: Administration of
Chemotherapy and Immunotherapy
IV sites to avoid - ANS- Extremities with impaired stream. Lymphedema, postoperative
swelling, trauma, proximity to an axillary node dissection, contamination, or an area of
decreased sensation can all affect the stream capability of veins. If your potential website
has any of these conditions, avoid it.
- Use lower extremities most effective if surely essential. Skin changes over those veins
could make insertion hard and growth the likelihood of capability extravasation. In addition,
you must keep away from any venipuncture website online that has been used for any
motive within the past 24 hours, if at all feasible.
- Antecubital veins. It is tough to stumble on infiltration on this location; because it's miles a
place of flexion, it is not best.
- Joints. If located over a joint, the motion of the joint may additionally reason kinking of the
catheter or gradual the infusion rate, which may produce phlebitis.
- Extremity on the aspect of a mastectomy. Because of the likelihood that an axillary node
dissection was carried out, if injury need to occur to veins on that aspect, any subsequent
systemic response might also reason extended swelling, which might not safely drain without
lymph nodes in the vicinity. This should result in persistent lymphedema.
Vesicants administered in PIV suggestions - ANS- Do not use an IV pump or syringe pump
so that the strain on the vein is minimized.
- Stay with the affected person during the infusion.
- Vesicant infusions through peripheral IV must remaining no longer than 30-60 mins.
- Verify blood go back each 2-5 ml for an IV push and every five-10 minutes for a quick
infusion.
Verification earlier than drug management - ANS- The order itself: If you do no longer use
standardized order units, the opportunity of error increases.
- If the man or woman writing the order has used abbreviations you do not normally see or
use, the opportunity of blunders increases.
- The extra complicated the routine is, the extra chances of error.
- If the routine is investigational or excessive-dose, extra risks may additionally follow.
- If the patient has comorbidities, these can have an effect on the bioavailability of a drug or
the affected person's reaction to it.
- If the affected person is taking different pills, there's a danger of drug-drug interactions.
Have you considered this threat? Sometimes supportive care capsules that ought to accept
might also have an effect on different coadministered tablets.
- Some drugs affect sure enzyme pathways. Should you be doing some thing approximately
that, along with informing the affected person to keep away from sure ingredients?
- Failing to use a constant double-check machine while verifying dose calculations will
increase the danger of mistakes.
- Failing to use present day height and weight when calculating the dose will increase the
threat of dosing mistakes.
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