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Year 2 Surgery > Lines, drains, and fluids > Flashcards

Lines, drains, and fluids Flashcards

1
Q

what are the peripheral access lines?

A

IV
PICC
intraarterial (A-line)

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2
Q

what are the central access lines?

A 
central venous catheter (CVC) 
cordis (pulmonary artery catheter) 
hemodialysis catheter (HD catheter) 
hickman catheter 
venous access port (VAP) 
arterial stick
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3
Q

what are the uses (2) for IV?

A
  1. routine medication administration

2. routine fluid resuscitation

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4
Q

what are the complications of IV?

A

pain during administration
infection
hematoma
infiltration

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5
Q

what is the location for PICC?

A

antecubital

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6
Q

what are the uses (3) for PICC lines?

A
  1. long term medication administration

2. poor IV access

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7
Q

can PICC lines be used for rapid fluid resuscitation?

A

NO

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8
Q

what are the complications of PICC lines?

A

venous thrombosis
malposition / dislocation
infection

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9
Q

what are the locations (3) for CVC?

A

internal jugular
subclavian
femoral

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10
Q

what are the uses (3) for CVC?

A

fluid resuscitation
multiple med lines
invasive monitoring (central venous pressure)

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11
Q

what are the complications of CVC?

A

pneumothorax
infection
arterial puncture

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12
Q

what are the locations (3) for a cordis?

A

IJ
subclavian
femoral

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13
Q

what are the uses (5) for a cordis?

A
  1. fluid resuscitation (rapid)
  2. pulmonary artery catheter
  3. invasive monitoring
  4. surgery with possible rapid blood loss
  5. multiple med lines if CVC fed through
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14
Q

what are the complications of a cordis?

A

pneumothorax

massive hemorrhage

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15
Q

what is the location of a PA catheter (Swan-Ganz)?

A

subclavian vein (through cordis)

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16
Q

what are the uses (3) for a PA catheter (Swan-Ganz)?

A
  1. critically ill with cardiac instability
  2. major CV surgery
  3. hemodynamic monitoring
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17
Q

what are the complications of a PA catheter (Swan-Ganz)?

A

pulmonary artery rupture
papillary muscle damage
valvular damage

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18
Q

what type of hemodynamic monitoring can be done with a PA catheter (Swan-Ganz)?

A

CO
SVR
pulmonary capillary wedge pressure (PCWP - volume status)

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19
Q

what is the location of a hemodialysis catheter?

A

IJ
subclavian
femoral

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20
Q

what are the uses (2) for a hemodialysis catheter?

A
  1. acute hemodialysis

2. chronic hemodialysis

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21
Q

what are the complications of a hemodialysis catheter?

A

clotting

bleeding

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22
Q

what are the locations (2) of a hickman catheter?

A
  1. subclavian

2. IJ

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23
Q

what is the use for a hickman catheter?

A

long term medication administration

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24
Q

what are the complications of a hickman catheter?

A

pneumothorax
bleeding
infection

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25
what are the locations (2) of a VAP?
1. subclavian | 2. IJ
26
what are the uses (2) of a VAP?
1. prolonged IV access (TPN) | 2. long medication administration (e.g. chemo)
27
what are the complications of a VAP?
dislocation | breakage
28
what are the common drains?
``` penrose jackson-pratt (JP) / blake hemovac chest tube / pleurovac T-tube enteral feeding tubes (NG, OG, G, J) ```
29
what is the use for a penrose drain?
free drainage of independent fluid
30
where are penrose drains placed?
neck (thyroid) | extremity
31
what does a penrose drain look like?
flimsy rubber tube
32
what are the uses (2) for a jackson-pratt drain?
1. post operative drainage of any potential space (inraabdominal, mastectomy, plastics flaps) 2. percutaneous drainage
33
what is the use for a hemovac drain?
post op drainage
34
what are the uses (4) for a chest tube / pleurovac?
1. trauma 2. pneumothorax 3. hemothorax 4. post-operative
35
what are the 3 types of T tubes?
1. cholecystectomy tubes 2. percutaneous transhepatic cholangiocatheter (PTC) 3. T tube
36
what are the uses (4) for T tubes?
1. drain biliary tract 2. post operative CBD exploration 3. drain obstruction biliary tract 4. acute cholecystitis
37
what are the two placements for G tubes?
1. percutaneous (PEG) | 2. open - surgical gastrostomy
38
what are the uses (3) for a G tube?
1. enteral feeding 2. drainage of stomach 3. fixation of stomach to abd wall
39
what are the complications of a G tube?
infection / abscess fall out / pulled out leakage
40
what is the use of a J tube?
feeding for patients with upper GI malignancy when G tube is contraindicated
41
is a J tube used for drainage?
no
42
what are the uses (2) of an NG / OG tube?
1. enteral feeding | 2. medications
43
what is the main complication of an NG tube?
aspiration
44
what are the goals (4) of fluid management?
1. contents and concentration 2. calculation of fluid requirements 3. bolus - what fluids to use 4. potassium replacement
45
I fluid replacement is based off what patient parameter?
urine output
46
what is the IV fluid rate for an adult?
UOP 1/2 mL/kg/hr
47
what is the IV fluid rate for a child?
UOP 1 mL/kg/hr
48
what is the IV fluid rate for an infant (up to 1 year)?
UOP 2 mL /kg/hr
49
what is the calculation of maintenance fluid for 24 hours?
100 / 50 / 20 rule 100 mL / kg for first 10 kg 50 mL / kg for next 10 kg 20 mL / kg for every divided by 24 hours
50
what is the calculation of maintenance fluid for 1 hour?
4 / 2 / 1 rule 4 mL / kg for first 10 kg 2 mL / kg for next 10 kg 1 mL / kg for every
51
what is the most common maintenance fluid for adults?
D5 0.5 NS with 20 mEq KCL / L
52
what is the most common maintenance fluid for pediatrics?
D5 0.25 NS with 20 mEq KCL / L
53
what type of fluids should be used in a bolus?
NS | LR
54
what is the maximum amount of potassium that can be given through a peripheral IV?
10 mEq / hour
55
what is the maximum amount of potassium that can be given through a central line?
20 mEq / hour
56
what are the mEq of sodium and chloride in NS?
154 mEq Na | 154 mEq Cl
57
what are the mEq of sodium and chloride in LR?
130 mEq Na | 110 mEq Cl
58
what are the pHs of NS and LR?
NS: 4-5 LR: 6.57 - 7
59
10 mEq of IV K raises serum K by how much?
0.1 mEq / L
60
how many mEq of IV K are required to raise serum K 0.1 mEq / L?
10 mEq

Year 2 Surgery (10 decks)

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