7A: Lines and Tubes

Question 1

Can a pt get up if they have an ICP monitor?

Answer 1

No - not even into sitting

Question 2

What are normal ICP levels in upright positions?

Answer 2

7-15 mmHg

Question 3

What patients will have an ICP monitor?

Answer 3

Head injury, brain surgery, intracranial hemorrhage

Question 4

What is an ICP monitor and why is it important?

Answer 4

Monitors pressure to make sure there is less risk of further damage

Question 5

What does IABP stand for?

Answer 5

Intra Aortic Balloon Pump

Question 6

Can you get up with an IABP?

Answer 6

Mostly not

Question 7

Hows does an IABP work?

Answer 7

Treaded up to the aorta and opens it more. Will inflate and deflate with the heart

Question 8

What does an IABP do?

Answer 8

Allows less pressure for the heart to pump against and takes stress off of the heart

Question 9

How will the pt’s condition change if it is inserted through the axilla?

Answer 9

Pt is able to move and possibly ambulate

Question 10

Where is a Swan-Ganz Catheter inserted?

Answer 10

Right side of the heart and threaded into the pulmonary artery

Question 11

What does a Swan-Ganz Catheter monitor?

Answer 11

Heart function and blood flow

Question 12

What patients will have a Swam-Ganz Catheter?

Answer 12

Very ill, mostly in the ICU

Question 13

Can you move a pt with a Swan-Ganz Catheter?

Answer 13

No ambulation - may be able to sit up in bed

Question 14

What is the purpose of a peripheral IV?

Answer 14

Administer saline or other medications

Question 15

What is the purpose of a triple lumen IV?

Answer 15

Able to administer multiple IV medications

Question 16

What pt’s will have a triple lumen IV?

Answer 16

Post-op cardiothoracic or other diagnoses

Question 17

Can you move a patient with a triple lumen?

Answer 17

Yes, just need to bring along the IV pole

Question 18

What is an art line?

Answer 18

Arterial line - measures present time BP in the artery

Question 19

What motion should be avoided with an art line?

Answer 19

Elbow flexion so you do not kink the line

Question 20

With MD approval, how can you move a patient with an art line?

Answer 20

Nursing has to disconnect it and then reconnect it after and zero it to reset it

Question 21

Without MD approval, can you move a patient with an art line?

Answer 21

Can get out of bed, but need to stay in or right next to bed

Question 22

What is a PICC line?

Answer 22

IV that is positioned in a large vein near the chest or heart

Question 23

What is a benefit of a PICC line?

Answer 23

Lower risk of infection since the line is really long

Question 24

When is a PICC line indicated?

Answer 24

Long term IV needs

Question 25

Can you mobilize a patient with a PICC line?

Answer 25

Yes

Question 26

What is the function of a CT?

Answer 26

Drain the chest cavity

Question 27

For standard use, where will a CT be located?

Answer 27

On the side that it is needed on

Question 28

Following cardiothoracic surgery, where will a CP be located?

Answer 28

In the middle to drain both sides of the chest

Question 29

How should you educate a pt about red fluid coming from their CT following surgery?

Answer 29

They are not actively bleeding, it is just excess fluids that need to be drained following the surgery

Question 30

How can you mobilize a patient if their CT is hooked to wall suction?

Answer 30

Need MD approval to disconnect, if not, then you have to stay in the room but can still be mobile

Question 31

Describe pt positioning with a CT

Answer 31

Needs to stay in a gravity dependent position relative to the chest

Question 32

How will a nasal cannula be manipulated during PT?

Answer 32

Taken off to see how much the pt will desaturate and wean them off over time

Question 33

What is important to keep in mind when mobilizing a patient with a catheter?

Answer 33

Need to keep it gravity dependent

Question 34

What type of EKG will typically be on a cardiac patient to monitor them?

Answer 34

5 electrodes - 3 leads

Question 35

Can you ambulate a pt with an EKG in the ICU?

Answer 35

Yes, you are able to disconnect for a few minutes and then re-connect them after ambulating

Question 36

What is an NG tube?

Answer 36

Placed into stomach via nose, used to put feeds into pt or to drain contents

Question 37

Can you mobilize a patient with an NG tube?

Answer 37

Yes - just bring the feeds with you

Question 38

Can you mobilize a pt if they have an NG tube being used for draining stomach contents?

Answer 38

Need MD approval to have nursing disconnect them from wall suction

Question 39

Can you mobilize a pt with Intermittent Pneumatic Compression Devices?

Answer 39

Yes - take them off for ambulation and then put them back on

Question 40

If a pt's Intermittent Pneumatic Compression Device is not on them when you enter the room, what should you do?

Answer 40

Do not put them back on, consult with nursing to see how long they have been off

Question 41

Do Ace wraps or slipper socks have an effect on your ability to mobilize a patient?

Answer 41

No - need to have either slipper socks or other shoes on in order to get out of bed