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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
Q

what are the locations (2) of a VAP?

A
  1. subclavian

2. IJ

26
Q

what are the uses (2) of a VAP?

A
  1. prolonged IV access (TPN)

2. long medication administration (e.g. chemo)

27
Q

what are the complications of a VAP?

A

dislocation

breakage

28
Q

what are the common drains?

A 
penrose 
jackson-pratt (JP) / blake 
hemovac 
chest tube / pleurovac 
T-tube 
enteral feeding tubes (NG, OG, G, J)
29
Q

what is the use for a penrose drain?

A

free drainage of independent fluid

30
Q

where are penrose drains placed?

A

neck (thyroid)

extremity

31
Q

what does a penrose drain look like?

A

flimsy rubber tube

32
Q

what are the uses (2) for a jackson-pratt drain?

A
  1. post operative drainage of any potential space (inraabdominal, mastectomy, plastics flaps)
  2. percutaneous drainage
33
Q

what is the use for a hemovac drain?

A

post op drainage

34
Q

what are the uses (4) for a chest tube / pleurovac?

A
  1. trauma
  2. pneumothorax
  3. hemothorax
  4. post-operative
35
Q

what are the 3 types of T tubes?

A
  1. cholecystectomy tubes
  2. percutaneous transhepatic cholangiocatheter (PTC)
  3. T tube
36
Q

what are the uses (4) for T tubes?

A
  1. drain biliary tract
  2. post operative CBD exploration
  3. drain obstruction biliary tract
  4. acute cholecystitis
37
Q

what are the two placements for G tubes?

A
  1. percutaneous (PEG)

2. open - surgical gastrostomy

38
Q

what are the uses (3) for a G tube?

A
  1. enteral feeding
  2. drainage of stomach
  3. fixation of stomach to abd wall
39
Q

what are the complications of a G tube?

A

infection / abscess
fall out / pulled out
leakage

40
Q

what is the use of a J tube?

A

feeding for patients with upper GI malignancy when G tube is contraindicated

41
Q

is a J tube used for drainage?

A

no

42
Q

what are the uses (2) of an NG / OG tube?

A
  1. enteral feeding

2. medications

43
Q

what is the main complication of an NG tube?

A

aspiration

44
Q

what are the goals (4) of fluid management?

A
  1. contents and concentration
  2. calculation of fluid requirements
  3. bolus - what fluids to use
  4. potassium replacement
45
Q

I fluid replacement is based off what patient parameter?

A

urine output

46
Q

what is the IV fluid rate for an adult?

A

UOP 1/2 mL/kg/hr

47
Q

what is the IV fluid rate for a child?

A

UOP 1 mL/kg/hr

48
Q

what is the IV fluid rate for an infant (up to 1 year)?

A

UOP 2 mL /kg/hr

49
Q

what is the calculation of maintenance fluid for 24 hours?

A

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
Q

what is the calculation of maintenance fluid for 1 hour?

A

4 / 2 / 1 rule

4 mL / kg for first 10 kg
2 mL / kg for next 10 kg
1 mL / kg for every

51
Q

what is the most common maintenance fluid for adults?

A

D5 0.5 NS with 20 mEq KCL / L

52
Q

what is the most common maintenance fluid for pediatrics?

A

D5 0.25 NS with 20 mEq KCL / L

53
Q

what type of fluids should be used in a bolus?

A

NS

LR

54
Q

what is the maximum amount of potassium that can be given through a peripheral IV?

A

10 mEq / hour

55
Q

what is the maximum amount of potassium that can be given through a central line?

A

20 mEq / hour

56
Q

what are the mEq of sodium and chloride in NS?

A

154 mEq Na

154 mEq Cl

57
Q

what are the mEq of sodium and chloride in LR?

A

130 mEq Na

110 mEq Cl

58
Q

what are the pHs of NS and LR?

A

NS: 4-5
LR: 6.57 - 7

59
Q

10 mEq of IV K raises serum K by how much?

A

0.1 mEq / L

60
Q

how many mEq of IV K are required to raise serum K 0.1 mEq / L?

A

10 mEq

Year 2 Surgery (10 decks)

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