Question

A 45-year-old female patient with breast cancer is scheduled to have a venous access device implanted that will allow chemotherapy drugs to be administered without continual venipuncture. This procedure will be performed under local anesthesia with monitored anesthesia care. These are the medications listed on the surgeon’s preference card:
Xylocaine 1% plain in a 10-cc vial
Heparin sodium 5,000 units per mL—3 mL
Heparin sodium 5,000 units in 500 mL normal saline for injection
Normal saline for irrigation—500 mL

Which medication is used to prevent the patient from feeling pain during the procedure?

What three items from the medication label must be verified when accepting medications onto the sterile field?

Which medication would be considered the “dilute” heparin solution and what is the concentration of that solution in units per mL?

Which medication is the “final flush” to assure that the device and its catheter are not occluded by a blood clot between uses and what is the total amount of heparin (in units) of that solution?

What medication is used to counteract the effects of heparin sodium if too much is administered or the effects of heparin sodium are no longer desired?

Answer 1

Which medication is used to prevent the patient from feeling pain during the procedure?

The local anesthetic used is Xylocaine 1%

What three items from the medication label must be verified when accepting medications onto the sterile field?

• Name of the drug
• Strength of the drug
• Expiry date of the drug

Which medication would be considered the “dilute” heparin solution and what is the concentration of that solution in units per mL?

Dilute 25,000 units of heparin to 50mls (25,000 units heparin in 5mls and 45mls of 0.9% sodium chloride) to produce a concentration of 500 units/ml.

Which medication is the “final flush” to assure that the device and its catheter are not occluded by a blood clot between uses and what is the total amount of heparin (in units) of that solution?

Heparin flush is used to assure the catheter is not occluded by blood clot. Heparin Sodium 100 I.U./ml Flushing Solution is used as Heparin flush.

What medication is used to counteract the effects of heparin sodium if too much is administered or the effects of heparin sodium are no longer desired?

Protamine sulfate (1% solution) by slow infusion will neutralize heparin sodium.