Lines, Drains, & Tubes

Question 1

Placement: Brachial Artery, Radial Artery, or Femoral Artery. Placed by MD

Indications: Used to monitor arterial blood pressure, access for arterial blood gas (ABG), and collecting blood for lab data (CBC, Chemistry, Etc)

Answer 1

Arterial Lines

Question 2

Placement: Any accessible vein (arm, leg, or foot). Usually placed by nurse for a duration of 3 days

Indications: Administration of drugs or fluids, blood transfusions, obtaining venous blood. CANNOT BE USED TO DRAW BLOOD

Answer 2

Intravenous Line

Question 3

Catheter that is threaded through the internal jugular vein, antecubital vein, basilic or subclavian vein with tip usually resting in superior vena cava or right atrium.

Answer 3

Central Lines

Question 4

Lines entering into the circulation through any peripheral vessel.

Answer 4

Peripheral Lines

Question 5

Placement: Subclavian, Internal Jugular, Basilic, or femoral vein into superior vena cava. Placed by an MD for a duration of 2 to 3 weeks.

Indication: Monitoring central venous pressures, administering drugs, fluids, and transfusions, or Total Parenteral Nutrition (TPN)

Answer 5

Central Venous Catheter

Question 6

Placement: Subclavian or internal jugular vein to pulmonary artery. Placed by MD

Indication: Monitoring heart pressures, cardiac output, core temperature, or pulmonary activity

Answer 6

Swan-Ganz Catheter (PA line or Pulmonary Artery Line)

Question 7

Placement: Basilic (most common), cephalic or median cubical vein to superior vena cava or inferior vena cava

Indication: Access for long term administration of TPN, Meds, fluids, blood products or chemotherapy

Answer 7

Peripherally Inserted Central Catheter (PICC)

Question 8

Purpose: Maintenance of normal cerebral perfusion pressure (CCP) and early ID or increased ICP

Keep head of bed @ 30 degrees

Normal ICP is 5-15mm Hg

Answer 8

Intracranial Pressure Monitoring (ICP)

Question 9

Name some factors that will increase ICP (Intracranial Pressure).

Answer 9

Lower Head of Bed (Trendelenburg)

Pain

Noxious Stimuli

Coughing

Question 10

Range of ICP that is cause for concern?

Abnormal range for ICP?

Range of moderate hypertension (HTN) ICP?

Severe life threatening intracranial HTN?

Answer 10

15-20mm Hg

> 20mm Hg

20 - 40mm Hg

> 40mm Hg

Question 11

Placement: Subarachnoid space via burr hold, placed by MD.

Indication: Short term use if cerebral edema prevents use of other devices.

PT: Rare for PT to get this patient into an upright position. If drug induced coma, pt will not waken from coma stimulation.

Answer 11

ICP Bolt

Question 12

Placement: Anterior horn of the lateral ventricle via a burr hole. Place by an MD (Gold Standard for measuring ICP)

Indication: Drainage or sampling of CSF, monitor ICP

PT: Needs to look for color change in drained CSF. Normal clear, pinkish, or straw colored.

Answer 12

Ventriculostomy (intraventricular catheter)

Question 13

Placement: Inflatable sleeves applied to leg (full leg or just lower portion)

Indication: Promote venous return and prevent DVTs

PT: Contraindicated over a leg with fracture, open wound, acute cellulitis and leg with DVT

Answer 13

Sequential Compression Device

Question 14

Placement: Given to patient at bedside. Patient breathes in through device.

Indication: To assist with deep breathing in hope to prevent pulmonary complications during hospital stays.

PT: Encourage pt to use often in bed.

Answer 14

Incentive Spirometer

Question 15

Placement: Placed at surgical site. Can be gravity assisted or suctioned.

Indication: Used to drain wound of edema and blood.

Answer 15

Constavac

Question 16

Placement: Placed at a surgical site. Placed by MD

Indication: Drainage of local edema/Blood

PT: Ensure device does not fall out. May pin to patient’s gown. But don’t forget to unpin!!

Answer 16

Jackson Pratt (JP)

Question 17

Placement: Colon is surgically opened and brought to the abdominal surface, bag placed by RN after surgery.

Indication: Bowel elimination when colon is obstructed or not functioning, there is a need for diversion of decal material

PT: Gait belt should be placed superior above site. Consider emptying bag before start of treatment

Answer 17

Colostomy/Ileostomy

Question 18

Placement: Rectum. Placed by RN

Indication: Rectal drainage, collect liquid stool, prevent skin breakdown secondary runny stool

Answer 18

Rectal Tube / Rectal Pouch

Question 19

Placement: Bladder. Place by RN

Indication: Bladder drainage

PT: Must be taken with patient always. Ask nurse for help when it needs to be drained.

Answer 19

Urinary or Foley Catheter

Question 20

Placement: Surgically placed in chest between ribs. Place by MD

Indication: Promotes normal intrapleural pressures/mechanics by 1) removing air or fluid from pleural space 2) Prevent re-entry of air/fluid 3) re-inflate a collapsed lung

Answer 20

Chest Tube

Question 21

Placement: Where needed

Indication: Used for suction of saliva, mucous, blood, or bodily fluids.

PT: This is your friend! Use it!

Answer 21

Suction (Yankauer suction)

Question 22

Placement: PVC tube in placed in trachea through an opening in the neck (stoma). Placed by an MD

Indication: Mechanical ventilation, prolonged ventilatory support, after a laryngectomy, tracheal resection, other head/neck surgeries.

PT: If patient is off of ventilator, be cautious of cough due to projectile

Answer 22

Tracheostomy (Trach)

Question 23

Placement: PVC tube placed in trachea via nose or mouth. Placed by MD

Indication: Used to relieve airway instruction, prevent aspiration, facilitate tracheal suction, mechanical ventilation.

PT: Should know if pt is weaning.

Answer 23

Endotrachial Tube (ET Tube)

Question 24

Placement: Surgically placed in the stomach/jejunum. Place by MD

Indication: Enteral feeding. Small intestine drainage, gastric drainage.

PT: Watch placement of gait belt and hands to prevent pulling out lines.

Answer 24

PEG/PEJ Tube

Percutaneous Endoscopic Gastostomy

Percutaneous Endoscopic Jejunostomy