Lines, Drains, and Fluids Flashcards
What are the three types of peripheral access lines?
IV
PICC
Intraarterial
What are the different central line accesses?
CVC
COrdis
HD cath
VAP
What are the complication associated with IV? (4)
infx
Hematoma
infiltrate
Pain during administration
What are the uses for an IV?
Routine med administration of fluids
What are the sites for IVs?
Any visible and/or palpable veins
What is the relationship between gauge and size?
Inverse
Where are PICC lines usually placed?
Antecubital fossa
What are the uses for PICC lines?
Long term administration
Poor IV access
What are PICC lines NOT used for? Why?
Fluid resuscitation– small lines
What are the three major complications with PICC lines?
Venous thrombosis
Malposition/dislocation
Infection
Where are central venous catheters placed? (3)
IJV
Subclavian
Femoral
Are CVC used for fluid resuscitation?
Yes
What are the three common complications with CVC?
Pneumothorax
Infx
Arterial puncture
What are the three uses for CVCs?
Fluid resuscitation
Multiple med lines
Invasive monitoring
What are the three locations for a cordis?
IJ
Subclavian
Femoral
What are the uses for Cordis?
Fluid resuscitation Pulmonary artery cath Invasive monitoring SUrgery with rapid blood loss Multiple med line
What are the two major complications with Cordis?
Pneumothorax
Massive hemorrhage
What are the locations of the PA cath?
Subclavian or IJV
What are the uses for a PA cath?
Critically ill with cardiac instability
Major cardiac surgery
Hemodynamic monitoring
What are the three major complications with PA caths?
Pulmonary artery rupture
Papillary muscle damage
Valvular damage
What are the hemodialysis caths used for?
IVJ
Subclavian
Femoral
What are the three major uses of hemodialysis caths?
Acute hemodialysis
Chronic hemodialysis
What are the two complications with hemodialysis catheters?
Clotting
Bleeding
What are the two locations of Hickman caths?
Subclavian
IJV
What is the major use of Hickman Caths?
Long term med
What are the three major complications with Hickman Caths?
Pneumothorax
Bleeding
Infx
What are the two locations for vascular access ports (VAPs)?
Subclavian
IJV
What are the two uses of VAPs?
Prolonged IV access
Long term chemo
What are the two major complications with VAPs?
Dislocation
Breakage
What are the six different types of drains?
- Penrose
- Jackson-pratt
- Hemovac
- chest tube
- Enteral feeding tubes
What is a Penrose drain? uses?
Rubber tubing placed in the neck or extremity to allow for free drainage of dependent fluids
What is a JP/Blake drain? Uses?
Semi-rigid plastic tubings that are attached to a suction device, to allow for postoperative drainage of a potential space or percutaneous drainage
What are hemovacs? What are they used for?
Self contained spring loaded drain that are used for suction post-op
What are chest tubes/pleuro vacs? Uses?
Drainage devices for hemothorax or pneumothorax
What are T-tubes, and what are their uses?
Cholecystotomy tubes or percutaneous transhepatic cholangiocatheter
What are the uses of T-tubes?
Drains biliary tract
Post-op CBD expansion
Acute cholecystitis
What are the three different types of enteral feeding tubes?
- G tube
- J tube
- NG/OG
What are G tubes?
Enteral feeding tubes that are placed through the abdominal wall into the gastric lumen, and are used for feeding or draining the stomach
What are PEG tubes?
Percutaneous endoscopic gastrostomy (G-tube)
What are J tubes?
Red rubber catheter from abdominal wall into the Jejunum for feeding
Are G tubes used for drainage? J tubes?
G tubes yes, J tubes No
How are J tubes placed?
Surgically
What are NG/OG tubes?
Nasogastric or orogastric tubes to used for enteral feedings/meds
What is the common complications with NG/OG tubes?
Aspiration d/t going through the LES
What are the electrolyte contents of NS? pH?
154 mEq for Na and Cl, at a pH of 4-5
What is the rate of IVF administration for adults, children, and infants?
Adults = UOP 1/2 ml/kg/hr Child = 1 ml/kg/hr Infants = 2 ml/kg/hr
How do you calculate the 24 hour IVF maintenance?
100 ml for first 10 kg
50 for next 10 kg
20 for additional kg
How do you calculate the maintenance fluid required per hour?
4 ml/kg for first 10 kg
2 ml/kg for next 10
1 ml/kg for additional kg
What two types of fluids are used for boluses?
NS or LR
Do you ever bolus dextrose or KCl?
never
What is the maximum amount of KCl that can be given through a peripheral IV? Central line
10 mEq/hr for peripheral
20 mEq/hr for central
10 mEq if IV K raises serum K by how much?
0.1 mEq/L
What are the electrolytes and concentrations for D5 half NS?
77 Na
77 Cl
50 Glu
450 free H2O
What are the electrolytes and their concentrations for LR?
130 Na 110 Cl 4 K 100 Free H2O 28 mEq lactate