7A: Lines and Tubes Flashcards
Can a pt get up if they have an ICP monitor?
No - not even into sitting
What are normal ICP levels in upright positions?
7-15 mmHg
What patients will have an ICP monitor?
Head injury, brain surgery, intracranial hemorrhage
What is an ICP monitor and why is it important?
Monitors pressure to make sure there is less risk of further damage
What does IABP stand for?
Intra Aortic Balloon Pump
Can you get up with an IABP?
Mostly not
Hows does an IABP work?
Treaded up to the aorta and opens it more. Will inflate and deflate with the heart
What does an IABP do?
Allows less pressure for the heart to pump against and takes stress off of the heart
How will the pt’s condition change if it is inserted through the axilla?
Pt is able to move and possibly ambulate
Where is a Swan-Ganz Catheter inserted?
Right side of the heart and threaded into the pulmonary artery
What does a Swan-Ganz Catheter monitor?
Heart function and blood flow
What patients will have a Swam-Ganz Catheter?
Very ill, mostly in the ICU
Can you move a pt with a Swan-Ganz Catheter?
No ambulation - may be able to sit up in bed
What is the purpose of a peripheral IV?
Administer saline or other medications
What is the purpose of a triple lumen IV?
Able to administer multiple IV medications
What pt’s will have a triple lumen IV?
Post-op cardiothoracic or other diagnoses
Can you move a patient with a triple lumen?
Yes, just need to bring along the IV pole
What is an art line?
Arterial line - measures present time BP in the artery
What motion should be avoided with an art line?
Elbow flexion so you do not kink the line
With MD approval, how can you move a patient with an art line?
Nursing has to disconnect it and then reconnect it after and zero it to reset it
Without MD approval, can you move a patient with an art line?
Can get out of bed, but need to stay in or right next to bed
What is a PICC line?
IV that is positioned in a large vein near the chest or heart
What is a benefit of a PICC line?
Lower risk of infection since the line is really long
When is a PICC line indicated?
Long term IV needs
Can you mobilize a patient with a PICC line?
Yes
What is the function of a CT?
Drain the chest cavity
For standard use, where will a CT be located?
On the side that it is needed on
Following cardiothoracic surgery, where will a CP be located?
In the middle to drain both sides of the chest
How should you educate a pt about red fluid coming from their CT following surgery?
They are not actively bleeding, it is just excess fluids that need to be drained following the surgery
How can you mobilize a patient if their CT is hooked to wall suction?
Need MD approval to disconnect, if not, then you have to stay in the room but can still be mobile
Describe pt positioning with a CT
Needs to stay in a gravity dependent position relative to the chest
How will a nasal cannula be manipulated during PT?
Taken off to see how much the pt will desaturate and wean them off over time
What is important to keep in mind when mobilizing a patient with a catheter?
Need to keep it gravity dependent
What type of EKG will typically be on a cardiac patient to monitor them?
5 electrodes - 3 leads
Can you ambulate a pt with an EKG in the ICU?
Yes, you are able to disconnect for a few minutes and then re-connect them after ambulating
What is an NG tube?
Placed into stomach via nose, used to put feeds into pt or to drain contents
Can you mobilize a patient with an NG tube?
Yes - just bring the feeds with you
Can you mobilize a pt if they have an NG tube being used for draining stomach contents?
Need MD approval to have nursing disconnect them from wall suction
Can you mobilize a pt with Intermittent Pneumatic Compression Devices?
Yes - take them off for ambulation and then put them back on
If a pt’s Intermittent Pneumatic Compression Device is not on them when you enter the room, what should you do?
Do not put them back on, consult with nursing to see how long they have been off
Do Ace wraps or slipper socks have an effect on your ability to mobilize a patient?
No - need to have either slipper socks or other shoes on in order to get out of bed
