Care of Patients w/ tubes, etc. (Ch. 15)

Question 1

When is the most vulnerable time for dislodgement of a tube or line on patient?

Answer 1

During patient transfers ( ex. from stretchcer to table)

Question 2

Any device today will be safe in a what type of magnet regarding the MRI studies?

Answer 2

3-t magnet

Question 3

What needs to be checked before doing MRI studies on a patient?

Answer 3

Make sure tube, catheter, pace-makers, etc are compatible with the magnet

Question 4

Explain what an Implanted device is and an example

Answer 4

• It is surgically implanted under the skin and may or may not be present outside of the body
• Ex: Cardiac pacemaker

Question 5

When are endotracheal tubes used?

Answer 5

-when there is a need for mechanical ventilation or oxygen delivery( during general anesthesia), severe airway obstruction, shock, impending gastric acid reflux, or in coma induced patients

Question 6

tracheal Intubation is achieved through what?

Answer 6

laryngeal (mouth) or nasal

Question 7

For long term ventilation for endotracheal tubes, what is performed?

Answer 7

Tracheostomy- an incision made in the windpipe to relieve an obstruction to breathing
(7-10 days)

Question 8

Some endotracheal tubes require what?

Answer 8

Respirators

Question 9

What is produced in patients that have endotracheal tubes and trachs?

Answer 9

secretions

Question 10

How are the secretions maintained from patients with endotracheal tubes and trachs?

Answer 10

Through suctioning and catheters - this clears out the airways of the patient and helps them to breathe better

Question 11

If a tube becomes filled with secretions, what happens?

Answer 11

The patient isn’t able to breathe

Question 12

Thoracostomy (chest) tubes are used to do what?

Answer 12

They are used to re-establish negative pressure in the pleural cavity

Question 13

What diseases are treated by thoracostomy tubes?

Answer 13

Pneumothorax, hemothorax, pleural effusion, and empyema

Question 14

What are thoracostomy tubes always attached to?

Answer 14

Pleuovac or Heimlick valve

Question 15

What types of situations involve the need to place a thoracostomy tube in a patient?

Answer 15

Trauma, complication of a lung biopsy, infection, rib fracture, open heart surgery

Question 16

Where should the pleuovac always be placed?

Answer 16

It should be lower than the chest to prevent reflux of drainage into the pleurospace

Question 17

What is hemothorax?

Answer 17

Blood in the thorax

Question 18

What is pneumothorax?

Answer 18

the presence of air or gas in the cavity between the lungs and the chest wall, causing collapse of the lung
*People can live with pneumothorax

Question 19

What is pleural effusion?

Answer 19

excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs.

Question 20

What is empyema?

Answer 20

the collection of pus in a cavity in the body, especially in the pleural cavity.

Question 21

What should happen if a chest tube is dislodged?

Answer 21

A vaseline dressing should be placed over the site to seal the puncture site

Question 22

How does the Heimlich vac operate?

Answer 22

It pushes air out and doesn’t let it back into the chest area keeping the pleural area negative

Question 23

What are two types of Gastrointestinal tubes?

Answer 23

NG - nasogastric and PEG tubs - used for feeding

Question 24

When are NG tubes used?

Answer 24

They are used after gastrointestinal surgery

• it suctions the secretions
• can also be used for feeding

Question 25

What are 3 Urological tubes?

Answer 25

- Foley catheter - Suprapubic tube - nephrostomy tube

Question 26

Foley catheter

Answer 26

- inserted into bladdar via urethra - held in bladdar with a balloon - attached to a drainage bag

Question 27

Where do you keep the drainage bag that is attached to a foley catheter?

Answer 27

The drainage bag of a foley catheter should be kept at a level below the bladder to prevent reflux back into bladder

Question 28

Suprapubic tube

Answer 28

Tube that is surgically placed into the bladder -Also attached to a drainage bag (directly placed from the skin into the bladder)

Question 29

When are suprapubic tubes most commonly used?

Answer 29

After prostate surgery

Question 30

Nephrostomy tube (where is it inserted)

Answer 30

Percutaneously insert into the calyx of the kidney

Question 31

Function of a Nephrostomy tube

Answer 31

To drain kidney when an obstruction is present in the ureter ex: kidney stones

Question 32

Where is the drainage bag kept at for a Nephrostomy tube?

Answer 32

Below level of the kidney

Question 33

Vascular Access Catheters

Answer 33

Are traditional intravenous catheters, always covered with a protective dressing

Question 34

Why are Other types of lines that are used to administer fluids, meds, and blood 9 used?

Answer 34

Used for patients where a peripheral intravenous line is unable to be maintained

Question 35

Examples of other types of lines besides vascular access catheters for patients

Answer 35

PICC (peripherally inserted central catheter), PORT, CVC's (central venous catheters), Arterial lines

Question 36

Most common insertion site for a CV catheter is what?

Answer 36

The subclavian vein | -other common sites include the internal jugular and femoral veins

Question 37

Ports are commonly used for patients receiving what?

Answer 37

Chemotherapy

Question 38

PICC's (peripherally inserted central catheter)

Answer 38

used where peripheral IV access is difficult or not possible | -also placed when long term IV access is needed ex: for long term antibiotic administration

Question 39

Arterial Line (art line)

Answer 39

used mainly for monitoring, and frequent blood drawing

Question 40

Tissue Drains

Answer 40

Used to drain collections of fluid, blood, or infectious matter -placed after surgery to prevent collection of fluid or blood within a wound

Question 41

Types of tissue drains

Answer 41

Jackson Pratt Drains, Hemovac

Question 42

Pain Balls

Answer 42

used to provide a continuous infusing to a wound for pain control

Question 43

Where is a Greenfield filter (IVC filter) placed and what does it do?

Answer 43

in the Inferior vena cava - traps blood clots and prevents them from reaching the heart and lungs

Question 44

How is a Greenfield filter inserted?

Answer 44

through the femoral vein and placed just below the kidneys usually in interventional radiology settings

Question 45

Caution must be taken with Greenfield filters in what setting?

Answer 45

MRI