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Clinical Integration Final > Lines, Tubes and Drains > Flashcards

Lines, Tubes and Drains Flashcards

1
Q

What is a peripheral IV line?

A

allows continuous access to venous system for meds, fluids etc.

consider avoiding BP over IV site

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2
Q

What is a PICC line?

A

peripherally inserted central catheter

inserts at: antecubital fossa/brachium

terminus: SVC

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3
Q

What is important to remember about PICC?

A

no BP over picc or proximal due to risk of blood clot in vein or thrombophlebitis

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4
Q

What is a Central venous catheter?

A

used for med, fluid administration that might not be able to go in smaller veins

higher risk of infection

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5
Q

Where does CVC insert?

A

internal jugular, subclavian or femoral vein

terminates in SVC

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6
Q

What is a non tunneled dialysis line?

A

quinton catheter- inserts in IJ, SC or femoral vein ends in central venous system

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7
Q

What are PT implications of a non tunneled dialysis line in femoral vein?

A

suggested that hip flexion greater than 30 degrees and other activity limitations due to length of line

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8
Q

What is a tunneled dialysis line?

A

longer term line with decreased risk of infection because line is tunneled beneath skin before entering vein

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9
Q

What are PT implications for tunneled dialysis line?

A

if located in UE avoid extremes of ROM

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10
Q

What is an Aline?

A

used for continuous blood pressure monitoring and ABG

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11
Q

Where is insertion usually of a line?

A

radial, brachial or femoral artery

terminates: short line, so several cm into the artery

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12
Q

What is a level transducer of an aline?

A

it measures the pressure and flushes system out

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13
Q

Where is the level transducer located?

A

The phlebostatic axis is the reference point for zeroing the hemodynamic monitoring device.

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14
Q

What are PT implications for an Aline?

A

range of motion may be limited at that joint and if you are mobilizing is that affecting the waveform of aline

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15
Q

Can pts with a femoral a line mobilize?

A

yes as long as line is secure and pts hemodynamic response is appropriate

just be very careful

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16
Q

What else can a central venous catheter do?

A

used with a transducer it can give central venous pressure and with other clinical signs can measure total body fluid balance

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17
Q

What is important to remember about CVC numbers?

A

may not be useful or accurate during mobilization

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18
Q

What is pulmonary artery catheter?

A

used to measure a variety of things like: CO, PA pressure, RA pressure, MVO2

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19
Q

Where is insertion of PAC?

A

insertion: peripherally IJ, rarely SC and femoral
terminus: branch of pulm artery

level of transducer at phlebo axis

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20
Q

What is a normal Central venous pressure?

A

2-5 mmHG

21
Q

What is normal right atrial pressure?

A

2-8 mm HG

22
Q

What is normal pulmonary artery pressure?

A

20-30 mmHG

23
Q

What is normal cardiac output?

A

4-8 L/min

24
Q

What is cardiac index ?

A

measures of heart performance, blood from left ventricle to body surface

norm: 2.6- 4.2 L/ min

25
Q

What is critical value for CI?

A

if less than 2.2 consider cariogenic shock

26
Q

What is a chest tube used for?

A

in plural space: the tube may remove air, blood or pleural fluid and/or infectious fluid

in mediastinum: tube drains fluid, usually post cardio thoracic surgery

27
Q

Where is chest tube insertion?

A

through intercostal space and terminates or plural space or mediastinum

28
Q

What are three settings a chest tube can be on?

A

suction, water seal or clamped

29
Q

What are PT implications?

A

maintain drainage collection upright and below insertion level

no restrictions on ROM

switch from suction to water seal during mobility?

30
Q

When can there be an emergency with chest tube?

A

if there is a disconnect in system such as chest tube falling off

31
Q

What is an air leak?

A

when air comes through the chest tube to the collection system, can be normal during a pneumothorax

32
Q

What are three types of surgical drains?

A

blake, jackson pratt or hemovac

33
Q

What is an intra aortic balloon pump?

A

mechanical device used to decrease myocardial oxygen demand and increase coronary artery perfusion

34
Q

How does this device work?

A

inflates during diastole in coordination with the cardiac cycle, deflates during systole

35
Q

Where does ballon pump insert?

A

peripheral artery, usually femoral

terminates: descending aorta

36
Q

What are PT implications for ballon pump?

A

most pts on this are on bed rest, no ipsilateral hip flexion greater than 30

37
Q

What is important to remember about a temporary pacemaker?

A

leads must be screwed in before mobility check orders from MD

38
Q

What kind of feeding tubes are temporary?

A

NG or NJ

39
Q

Which kind of feeding tubes are more permanent?

A

g tube or j tube inserted percutaneous to reduce risk of aspiration can lead to GI bleed, skin breakdown

40
Q

When is Total parental nutrition used?

A

reserved for patients who cannot use their GI tract due to dysmotility, ischemia, obstruction or surgery

administered through venous access line

41
Q

What are two types of ICP monitors?

A

ICP bolt and ventriculostomy ( can CSF)

42
Q

What are PT implications for ICP?

A

watch for waveforms as this may be a sign of cerebral hypoxia or ischemia

if ICP elevations over 5 mins notify RN

keep HOB at 30 degrees

43
Q

What is an endotracheal tube?

A

temporary maintenance or airway potency and delivery of mechanical ventilation

44
Q

What is a tracheostomy tube?

A

“trach” inserted near thyroid cartilage and used for intermediate or permanent airway management

45
Q

Are trachs used with technical vents?

A

sometimes but not always

46
Q

How much air does a regular nasal cannula deliver?

A

can deliver between 0.25-6.0 L/min

FiO2 increases by 4% liter per min

47
Q

What is a high flow nasal cannula?

A

up to 60 L/min

FiO2- 21%-100%

benefits: humidified, reduced entrainment of room air, can eat, drink talk easier than with a mask

48
Q

How much air can a simple mask deliver?

A

6 -10 L/min

35-50% fiO2

can’t use with a trach

49
Q

What is a venturi mask?

A

provides .24-50% FiO2

useful for mobility if pt doesn’t require more than 50% FiO2

Clinical Integration Final (5 decks)

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