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PROCEDURE FOR
ADMINISTERATION OF INTRAPERITONEAL CHEMOTHERAPY (IP)
(CHEMOTHERAPY ADMINISTERED DIRECTLY INTO THE
ABDONIMAL AND PELVIC CAVITY)
PURPOSE:
To provide directions for the administration of intraperitoneal chemotherapy
EQUIPMENT:
-
Subclavian Catheter Care Kit
-
1 Huber Needle (non-coring
needle) 20 or 22 gauge
-
1 package of steri-strips
-
2 10 ml syringes
-
2 18 gauge needles
-
2-3 2X2 gauze dressing or 1
band-aid
-
2 20ml vials of normal
saline
-
1 sterile specimen cup (if
ordered to obtain specimen)
-
IV tubing with Y site or
peritoneal dialysis tubing (with Y site and drainage bag if drainage is
ordered.)
-
IP chemotherapy in 500
ml-2000 ml normal saline
PROCEDURE STEPS:
ACCESSING THE PORT
Using sterile procedure, access the IP per Nursing Procedure #182 “ Procedure
for the Use and Maintenance of Implantable Infusion Port”.
KEYPOINT:
Peritoneal ports should not have a blood return.
ADMINISTRATION OF
CHEMOTHERAPY
- Warm infusate to body
temperature using IV fluid warmer.
- Infuse chemotherapy as
ordered and leave in abdominal cavity.
KEYPOINT:
The patient must be instructed to turn from side to side every 15 minutes for 2
hours after infusion to increase distribution of chemotherapy in the abdominal
cavity.
KEYPOINT:
Chemotherapy generally should be infused into the abdomen as rapidly as
possible. Fluid amount for chemo and also post infusion fluid will vary.
Sometimes the chemo is placed in 2000 ml and no further fluid is placed after
the infusion is complete; sometimes it is placed in less fluid and followed with
a liter of normal saline.
REMOVAL OF NON-CORING NEEDLE
Refer to Procedure #182 “Use and Maintenance of
Implantable Infusion Port”.
POTENTIAL COMPLICATIONS
- Pain from abdominal
distention, adhesion formation
- Dyspnea, respiratory
distress
- Bacterial Peritonitis
- Chemical Peritonitis
- Wound exit site infection
- Other adverse effects
secondary to the chemotherapeutic agents used
- Possible extravasation of
chemotherapy/fluid if needle is dislodged
- Occlusion of catheter
- Possible bowel
perforations
REFERENCES:
Almadrones, L., Yerys, C. (1990). Problems
associated with Intraperitoneal Therapy given through the Port A Cath System.
ONF.
Oncology Nursing Society Clinical Practice
Committee. (1996). Venous Access Device Guidelines-Module II Ports &
Reservoirs. Oncology Nursing Society.
RESOURCE PERSON(S):
Donna Dunn, ANP, MNSc; Tonie Durrett, RN, MNSc; Susan Smithwick, RN, BSN
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