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Patient Care > Chapter 14 > Flashcards

Chapter 14 Flashcards

1
Q

What is NG Tube?

A

Nasogastric Tube
plastic or rubber tubes
Inserted through the nasopharynx into the stomach

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2
Q

NG Tube is used for

A 
Administration of medications
Gastric decompression (most common) 
Removal of gas (flatus) & fluids from stomach after intestinal obstruction or major trauma
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3
Q

5 types of NG tube are

A 
Levin (common)
Sump (common)
Nutriflex
Moss
Sengstaken-Blackemore (S-B)
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4
Q

Levin tube

A

Most common
1 lumen
Plastic
Passed through nose into stmach

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5
Q

Levin tube used for

A

Gastric decompression

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6
Q

Sump tube also called

A

Salem-sump tube

Most common

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7
Q

Sump tube is

A 
Double-lumen 
Blue extension (* pig-tail) is the 2nd lumen
Lets air flow into stomach
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8
Q

Nutriflex tube

A

1 lumen
mercury-weight tip
feeding

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9
Q

Moss tube

A

3 lumen-complex
Balloon to anchor into stomach
2nd & 3rd lumen used for aspiration & feeding

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10
Q

Sengstaken-Blackemore tube

S-B

A

3 lumens
thick catheter
2 balloon
control bleeding from esophagus

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11
Q

Nasogastric Tube Equipment

A 
NG tube
Water-soluble lubricant
20 to 50 ml syringe
Tetracaine
Contrast (under fluoro in correct place)
Tissue
Tape 
Emesis basin
Gloves
Towels
Glass of water with straw
Saline (flush it)
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12
Q

Nasoenteric Tube (NE Tube)

A

Same material as NG tubes
Inserted same as an NG
Passes into duodenum & small intestines by peristalsis
Weighted metal tip (single)

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13
Q

NE Tube used for

A

Decompression
Diagnosis
Treatment

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14
Q

3 types of NE tube

A

Cantor
Harris
Miller-Abbott

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15
Q

Entriflex / Dobhoff tube

A 
Single narrow lumen tube with removable wire stylet
Placed into duodenum or jejunum
Not used with suction
Thinner & more flexible than NG tubes
Leave in for long periods of time
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16
Q

Gastrostomy Tube

A

A surgical creation of an opening into the stomach from where a tube is placed from inside the stomach to the external abdominal wall

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17
Q

Gastrostomy Tube Used for

A

Feeds a patient who cannot tolerate the intake of oral food

Temporary or permanent

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18
Q

Most common type of Gastrostomy Tube is

A 
PEG tube (percutaneous endoscopic gastrostomy)
Placed during endoscopy or surgery
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19
Q

Central Venous Lines also called

A

central venous catheters or venous access devices

Also named for developer – Hickman or Groshong

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20
Q

Central Venous Lines

A 
Wide variety of clinical application
Administer a variety of drugs
Manage fluid volume
Serve as a conduit for blood analysis & transfusions
Monitor cardiac pressure
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21
Q

Central Venous Lines mainly used for

A

chemotheraphy & parenteral nutrition

May be single-, double-, or multi-lumen

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22
Q

Most common insertion site of Central Venous Lines is

A

Subclavian vein

Can also use internal jugular & femoral veins

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23
Q

Position of Central Venous Lines should be

A

Superior vena cava – approximately 2 to 3 cm above opening of right atrium

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24
Q

Pulmonary Arterial (PA) Catheter also called

A

Swan-Ganz catheters

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25
Q

Pulmonary Arterial (PA) Catheter

A

Single- or multi- lumen CV lines
Incorporates a small electrode @ distal end, used to monitor arterial pressure
Distal tip will be in one of the two pulmonary arteries
Enters through the right internal jugular & ends in right PA

26
Q

Peripherally inserted central catheter (PICC)

A

Inserted by a nurse/radiologist/or specially trained radiographer
Inserted into the patient’s arm and advanced until its tip lies in a central vein (best side of pt)

27
Q

Implanted Access Port

A

Port-A-Cath, Infusa Port, Mediport (lung)(pt w/port not have a good vein)

28
Q

Implanted Access Port used for

A

Patients with long term illnesses requiring frequent IV medications or transfusions

29
Q

Implanted Access Port made of

A

plastic, titanium or stainless steel

30
Q

Implanted Access Port Implanted into

A

the subcutaneous tissue of the chest
Not visible but can be palpated
Catheter from the port is inserted into the subclavian or internal jugular vein
Utilizes a huber needle

31
Q

Emergency Suctioning indication

A

Profuse vomiting in a patient who can not voluntarily change their position
Audible rattling or gurgling sounds coming from patient’s throat
Signs of respiratory distress

32
Q

Emergency Suctioning purpose

A

To prevent aspiration or respiratory arrest

It is not within our practice to perform suctioning.

33
Q

Contraindications for Suctioning

A 
Head or facial injuries
Bleeding esophageal varices
Nasal deformities
Trauma
Cerebral aneurysms
Tight wheezing, bronchospasm or croup
34
Q

Suctioning Equipment

A 
Wall outlet or working portable suction machine
Sterile gloves
Tubing
Disposable suction set with various catheter sizes
10 F to 18 F Adults
5 F to 8 F Children
Sterile container for solution
Sterile water or sterile normal saline
Oxygen 
Gown, mask and goggles
35
Q

Tracheostomy

A

An opening into the trachea that is created surgically to provide a temporary/permanent artificial airway to a patient
Provides an airway during upper airway obstruction

36
Q

Tracheostomy Tube Indications

A

Traumatic injury
Paralyzed
Unconscious or suffering from disease which has affected respiration

37
Q

Tracheostomy Tube Precautions

A 
Metal or plastic design
Cuff
Helps to seal the tracheostomy to prevent air leaks or aspiration
Ties to hold in place
Do not untie and do not remove the tube
Patients are suctioned
Explain procedure to patient
38
Q

Mechanical Ventilator

A

Artificial airway connected to a mechanical ventilator
Patients are not able to breath spontaneously
Endotracheal tube or tracheostomy tube

39
Q

Ventilator delivers

A

a minimum set respiratory rate, preset inspiratory volume, and consistent FiO2
Radiographs may be taken to confirm correct placement

40
Q

Manual ventilation

A

Use an Ambu bag (blue color)
A device that is squeezed regularly by hand to force respirations
Used during transportation and when setting up ventilation

41
Q

Clinical term used is for Ambu bag is

A

“bagging patient”

42
Q

Endotracheal Tubes

A

Tube inserted through the mouth into the trachea with correct placement of tip 5 to 7 cm above the tracheal bifurcation

43
Q

Endotracheal Tubes Indications for use

A

Need mechanical ventilation or oxygen delivery due to inadequate breathing
Inadequate arterial oxygenation
Parenchymal diseases that impair gas exchange
Upper-airway obstruction
Impending gastric acid reflux or aspiration

44
Q

Endotracheal Tubes: Radiographs needed for placement and thereafter

A

20% require repositioning of tube
Malpositioning into right main-stem bronchus which causes overventilation of right lung & possible airway obstruction to left (atelectasis)

45
Q

Thoracostomy Tubes also called

A

CHEST TUBE

46
Q

Thoracostomy Tubes USES FOR

A 
Drain intrapleural space & mediastinum
Fluid or air accumulate
Creates a negative pressure
Fluid or air accumulate causing pressure to be lost and the lungs fail to expand fully
If too low a pressure, lungs collapse
47
Q

Thoracostomy Tubes Condition

A

Pneumothorax (air)
Hemothorax (blood)
Pleural effusion (fluid)
Empyema (infective)

48
Q

Thoracostomy Tubes insertion site vary

A

with the intrapleural substances to be removed (pt can have more than 1 chest tube)

49
Q

Fluids (hemothorax or pleural effusion):

A

usually inserted in 5th to 6th intercostal space

Can be as high as 4th intercostal space and as low as 8th

50
Q

Air (pneumothorax):

A

requires a higher insertion because air rises

2nd to 3rd intercostal space @ midclavicular line

51
Q

Tissue Drains

A

Placed at or near a wound site or operative site

One end of the tube or drain is placed in or near the operative site, and the other end exits the body wall

52
Q

3 common postoperative drains

A

Hemovac
Jackson-Pratt
Penrose

53
Q

Penrose drain

A

Soft rubber tube
Sterile safety pin keeps tube from slipping into surgical wound
Drains into a surgical dressing

54
Q

Jackson-Pratt and Hemovac drains

A

Plastic drainage tube
Maintains a constant low negative pressure
Drainage goes from tubing into bulb
Used for hip surgeries

55
Q

Urinary Catheters

A 
Indwelling catheter (catheter that remains inplace)
Insertion of a tube into the bladder using aseptic technique
56
Q

Two main types of Urinary Catheters

A 
Retention balloon (Foley) (B)
Straight type (A)
57
Q

How to Use French system for sizing

A

8 F to 18F (outer diameter of catheter)

Choose larger size when possible

58
Q

Balloon is filled with

A

Balloon is filled with sterile water to hold catheter in place after insertion

59
Q

Drainage bag must be

A

kept lower than patient’s bladder @ all times to prevent retrograde flow into bladder
Failure to do so can lead to infection
Bags should never drag on floor

60
Q

When transferring patients by wheelchair or stretcher

A

Ensure that the drainage bag & tubing do not become entangled in wheels or caught on passing objects.

61
Q

Urinary Catheter purposes

A 
Bladder emptying
Relieve bladder retention
Irrigate bladder
Introduce drugs into bladder
Permit accurate measurement of urine output
Relieve incontinence

Patient Care (19 decks)

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