Acute Care Devices Flashcards
1
Q
Things to decide with tubes/lines when entering the room
A
- Can I mangage all these lines and tubes myself
- Do I need help
- I have never seen this tube, I need to ask someone first
- Move the lines to the side of mobility
2
Q
Feeding tubes are names by
A
insertion site to where they go
3
Q
A
Nasogastric (NG tube)
4
Q
A
TPN
5
Q
A
- Percutaneous Tube
- PEG
- Need to be aware of gate belt placement
6
Q
PT Implications - Feeding Tubes
A
- NG feeding tubes should be stopped and patient positioned upright got 30 minutes (1 hour in pediatrics) before supine activites (Patient should not lie flat)
- Some patients have continuous feeding nutrition, need IV pole along with you for transportation and/or gait activities
- May be able to have tube disconnected, contact nurse to do
- Be aware of gait belt placement with PEG tube
7
Q
Indwelling (Foley) Catheter and collection bag - Considerations
A
- Keep collection bag below bladder level.
- Avoid tension on tubing.
- Drain urine from tubing before activity; you may have to drain collection bag – MUST measure and document and/or inform nurse
8
Q
Condom (Texas) catheter and collection bag - considerations
A
- For use only with male patients
- Easy to remove accidentally
9
Q
Surgical insertion - considerations
A
- Keep insertion site dry.
- Avoid placing gait belt over the insertion site.
10
Q
Suprapubic and Indwelling Catheter - Considerations
A
- Collection bag with gravity drainage
11
Q
Nephrostomy - Considerations
A
Tube goes to kidney; located in the back
Be careful with gait belt
12
Q
Colostomy/Ileostomy and collection bag
A
- Attached directly to the large intestine through surgical opening in abdomen.
- Bag may need to be emptied prior to mobility (patient or nurse)
- Maintain secure attachment of bag.
- Keep bag attachment dry.
- Be aware of gait belt placement.
Stoma is opening; ostomy pouch
13
Q
Rectal Tube - Considerations
A
- Inserted into rectum with collection bag.
- Can easily become dislodged.
- Keep bag below level of tube.
- Use “slippery sheet” for mobility activities.
- Patients may be uncomfortable in seated positions.
14
Q
The more central a lines is, the ____ critical its distrubance
A
more
15
Q
What type of line is the most dangerous if dislodged?
A
Arterial due to higher pressures! Blood will pump out faster.
17
Q
Periperal Intravenous (IV) Line
A
- For administering medications and fluids
- Typically, in peripheral vein on forearm or back of hand; also, neck, leg, or foot
- Avoid blood pressure (BP) cuff on limb with IV.
- Maintain drip bag above insertion site.
- Avoid occluding or placing tension on the line.
- Notify nursing staff if insertion site is swollen or red.
18
Q
Patient Controlled Analgesia via IV
A
- Patient uses push-button to deliver pain medication through IV via electronic pump. Almost instant relief.
- Total amount is controlled to prevent overmedication.
- Typically seen immediately post-surgically with weaning process to oral medications
- Avoid occluding tubing; alarm may sound
- Coordinate mobility activities with pain control
- Ensurepush-button is within patient reach at end of session
- When it pops up green the patient will be able to give themselves another dose
- PT is NOT allowed to press the button; you can only notify them that it may be beneficial to hit it.
19
Q
PICC - Considerations
A
- Inserted in vein of upper extremity, terminating in superior vena cava
- Allows for administering drugs and fluids long term
– Chemotherapy
– Dialysis treatments - Avoid placing a BP cuff on arm with PICC.
- Use of axillary crutches may be contraindicated (if placed in basilic vein)
23
Q
Sequential Compression Device - Considerations
A
- Sleeves placed on patients legs and attached to inflation pump
- Compression is graduated distal to proximal to return venous blood to heart
- Can be removed for mobility (Exercise preceds these!)
32
Q
Jackson Pratt (JP) drain
A
- Tubing from surgical site to suction bulb; Wound drainage
- Drains and collects excess fluid from surgical site
- Drain usually attached to patient’s clothing via safety pin
- Have nursing staff drain before the activity if more than half full
- Be careful with gait belt placement
33
Q
Hemovac
A
- Wound drainage
- Tubing from surgical site to collection canister
- Drains and collects excess fluid from surgical site
- Drain usually attached to patient’s clothing via clip
34
Q
Chest Tube - Considerations
A
- Large-bore tube inserted into chest cavity
– Mediastinal (12-24 hours post-operative)
– Pleural (1-3 days post-operative) - Drains excess fluid or maintains pulmonary inflation
- Tube attached to wall suction unit or water-sealed bedside container
- Keep bedside container upright and below insertion site
- Do not place gait belt over or under chest tube site; Go under the armpits
- Accidental removal of chest tube is a life-threatening emergency!
35
Q
Wound VAC
A
- For large non-healing wounds or pressure ulcers, diabetic ulcers
- Can be placed anywhere on the body
- Surgically placed sponge (blue part) with negative pressure vacuum suction to cannister
- Brings blood and tissue to the area
- Vacuum device can run on battery power, making mobility possible
- Dressing replaced every 24-72 hours depending on drainage andhealing status
- Be aware of wound / line location for gait belt placement / safety
- This is gold standard compared to e-stim with chronic wound.
