Which statement best describes the nursing assessment for patency with a direct-push method of administering a chemotherapy vesicant?

• A. Assess for blood return before the infusion, every 2-5ml, and for blood return and pain at the end of the infusion
• B. Assess for blood return before the infusion and at the completion of the infusion
• C. Assess for blood return before the infusion and for pain at the completion of the infusion
• D. Assess for blood return before infusion, every 5-10ml, during the infusion, and at the end of the infusion

Answer: (A)

Patency checks for a vesicant given by direct-push hinge on keeping the line in the vein and detecting early signs of extravasation, because vesicants can cause serious tissue injury if they infiltrate the surrounding tissue. Start by confirming blood return before you begin so you know the catheter is in a vein. Because the drug is given directly into the line, you need to monitor frequently as you infuse—checking every 2-5 mL allows you to detect a sudden loss of patency or early infiltration while there’s still a chance to intervene. Finally, reassess at the end of the infusion for blood return and to note any new or worsening pain, which can signal extravasation. This approach provides timely detection and supports safe administration of a vesicant.