Alt Med Treatment

Question 1

What are NG Tubes? (Where is it inserted?)

Answer 1

Plastic/rubber tubes inserted through nasopharynx into stomach

Question 2

What are NG tubes used for?

Answer 2

Administer medication; Gastric decompression/ removal of gas (flatus) & fluids from stomach after intestinal obstruction/major trauma

Question 3

What is the most common NG tube?

Answer 3

Levin Tube

Question 4

Who is responsible for inserting NG tube? (What should be prevented?)

Answer 4

Physician or Nurse; must prevent accidental withdrawal of tube after insertion

Question 5

What is a Sump tube?

Answer 5

Salem-sump tube; double-lumen tube with an air vent; blue extension is 2nd lumen, remaining open for air to enter stomach, allowing tube to free float

Question 6

What are Nasoenteric Tubes? (Where are they inserted?)

Answer 6

Made of same material as NG tubes; Inserted like NG tube but passes through duodenum & small intestines by peristalsis & weighted metal tip

Question 7

What are NE tubes used for?

Answer 7

Decompression, Diagnosis, Treatment

Question 8

What is an Entriflex/Dobhoff tube?

Answer 8

Single narrow lumen w/ removable wire stylet; placed in duodenum/jejunum; more thin & flexible than NG tubes; leave in for long periods of time

Question 9

What is a Gastronomy Tube? (Definition, placement & purpose)

Answer 9

Surgical creation of opening into stomach; tube placed inside stomach to external abdominal wall; feeds patient who cannot tolerate oral food intake

Question 10

What is the most common Gastronomy tube?

Answer 10

PEG (percutaneous endoscopic gastronomy)

Question 11

What are Central Venous Lines? (Alternate name, types, insertion area, position)

Answer 11

Central venous catheters or venous access devices; single, double or multi-lumen; Catheters inserted into large vein (most common subclavian; internal jugular/femoral); placed in superior vena cava (2-3cm above right artium opening)

Question 12

What are Central Venous Lines used for?

Answer 12

Chemotherapy and parenteral nutrition; Administer variety of drugs, Manage fluid volume, Conduit for blood analysis/transfusion, Monitor cardiac pressure

Question 13

What is a Pulmonary Arterial (PA) Catheter?

Answer 13

Swan-Ganz catheters; single or multi lumen Central Venous lines; has small electrode @ distal end to monitor arterial pressure

Question 14

How is a Pulmonary Arterial (PA) Catheter inserted?

Answer 14

Distal tip in one of the two pulmonary arteries; enters through right internal jugular and ends in right PA

Question 15

What is a PICC line? (Who inserts it, where is it inserted)

Answer 15

Peripherally inserted central catheter; inserted by nurse, radiologist or specially trained radiographer; inserted in patients arm @ advanced until tip is in central vein

Question 16

What is an implanted access port? (Alternate names, who needs them, material)

Answer 16

Port-A-Cath, Infusa Port, Mediport; Pts with long term illnesses, requiring frequent IV meds/transfusions; made of plastic, titanium or stainless steel

Question 17

Where are access ports implanted?

Answer 17

Into subcutaneous tissue of chest; catheter from port and inserted into subclavian or internal jugular vein

Question 18

What are indications for suctioning and its purpose?

Answer 18

To prevent aspiration/respiratory arrest; profuse vomiting in pts who cannot change position, rattling/gurgling, respiratory distress

Question 19

Suctioning contraindications

Answer 19

Head/face injuries, nasal deformities, trauma, cerebral aneurysms, tight wheezing

Question 20

What are the suctioning catheter sizes?

Answer 20

10F - 18F for adults; 5F - 8F for children

Question 21

What is a tracheostomy?

Answer 21

Opening in trachea to provide temporary/permanent artificial airway; provides airway during upper airway obstruction

Question 22

What are tracheostomy indications?

Answer 22

Traumatic injury, paralysis, unconscious/suffering respiration disease

Question 23

What is a mechanical ventilator?

Answer 23

Artificial airway connected to mechanical ventilator (endotracheal tube or tracheostomy tube)

Question 24

What are endotracheal tube indications?

Answer 24

Need mechanical ventilation or oxygen; upper airways obstruction; diseases that impair gas exchange; gastric acid reflux or aspiration

Question 25

How are endotracheal tubes inserted?

Answer 25

Through mouth into trachea with tip 5cm - 7cm above tracheal bifucation; 20% require repositioning

Question 26

What are Thoracostomy tubes? (Alternate name, purpose & conditions)

Answer 26

Chest tubes; drains intrapleural space/mediastinum, keeping pressure for proper breathing; Pneumothorax, hemothorax, pleural effusion, empyema

Question 27

How are Thoracostomy tubes inserted?

Answer 27

Vary w/ intrapleural substances to be removed; Fluids (hemothorax/pleural effusion) 5th to 6th intercostal space (sometimes 4th to 8th); Air (pneumothorax) higher insertion because air rises (2nd to 3rd intercostal space @ midclavicle)

Question 28

What are tissue drains and the three most common postoperative drains?

Answer 28

Placed at/near wound/operative site; one end near site, other end exits body wall; 3 postoperative drains: Hemovac, Jackson-Pratt, Penrose

Question 29

What is a Penrose Postop tissue drain?

Answer 29

Soft rubber tube that drains into surgical dressing

Question 30

What is a Jackson-Pratt and Hemovac tube?

Answer 30

Plastic drainage tube, draining into bulb; hip surgeries; maintain constant low negative pressure

Question 31

What are urinary catheters? (Definition, insertion, types & sizes)

Answer 31

Indwelling/stationary catheter; inserted through aseptic technique; 2 types: Retention balloon/Foley, Straight type; 8F - 18F