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EMER 116 > LO4 Home health patient > Flashcards

LO4 Home health patient Flashcards

1
Q

What is a home health patient?

A

Any patient who participates with routine health care in their home, with the assistance of a health professional

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2
Q

Central line

A

IV catheter where the tip ends in a large blood vessel usually right vena cava
Pts who need iv access for longer periods of time

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3
Q

PICC

A

Peripheral inserted Central Catheter

Thin, soft, long catheter

Inserted in vein in neck or arm usually upper arm

Fed through and sits at the top of the right atria/superior vena cava

30-60cm in length 5-6 french

Can stay in for upwards of a year

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4
Q

TICC

A

Tunnely inserted central catheter

Inserted through tissue on chest until it enters the vein then catheter sits at top of atria

Can have 1,2 or 3 lumens

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5
Q

Port-A-Cath

A

No part of the port -a-cath is outside of the body

Have to pierce through the skin every time for access

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6
Q

CVL

A

Central venous line

Inserted into usually the jugular or subclavian

No longer than 5 days

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7
Q

Ostomies

A

A hole made by surgery to let something from the inside of the body to leave out

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8
Q

Colostomy

A

large colon

Ascending- right side of abdomen
liquid

Transverse- across the middle of the abdomen
Liquid to semi formed

Descending- left side of the abdomen
Formed but squishy

Sigmoid- lower left side of abdomen
Fully formed

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9
Q

Ileostomy

A

Discharge after an ileostomy is liquid or pasty in consistency, dark green, odorless, and occurs several times a day, usually after meals.
Small intestine

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10
Q

Urostomy

A

Ureters being pulled out

Urine doesn’t go to bladder

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11
Q

Replacing an ostomy device

A

Removes pouch and wafer

Cleanse

Assess stoma and surrounding area

Measure stoma for wafer

Prepare wafer

Applies skin protectant

Apply wafer and pouch appropriately

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12
Q

Nasogastric tubes

A

are of sufficient length to pass through the nose and pharynx, down to the esophagus and into the stomach

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13
Q

Nasogastric tubes Indications for use:

A

Decompression of the stomach and small intestine

Evacuation of blood or secretions

Evacuation of ingested drugs or toxins

Instillation of medications and feedings

Obtaining of gastric contents for analysis

Administration of warm fluid to correct hypothermia

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14
Q

Leven

A

Single lumen

Short term use- put in use and take out)

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15
Q

salem sump

A 
Double lumen
Can be attached to suction 
Can remove stomach content 
Can put something in the stomach 
Can deflate air out of stomach
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16
Q

NG tube placement and sizes

A

Measures by Distal tip to xiphoid process fold up around ear and bring to tip of nose

Tube sizes are 12, 14, 16, and 18 French. The most commonly used sizes are 14 and 16.

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17
Q

NG tube complications

A

Nose bleeds
Vomiting
Aspiration
Tissue trauma

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18
Q

orogastric tubes

A

An orogastric tube is a large bore tube that is passed through the oropharynx, down the esophagus and into the stomach. Its main purpose is for facilitation of gastric lavage

19
Q

Ewald OG tube

A

is a single-lumen tube that has several openings at the distal end that allows for aspiration of large amounts of gastric contents quickly

20
Q

The Levacuator OG tube

A

is a double-lumen tube that allows for continuous instilling of fluid through the small lumen, while at the same time evacuating gastric contents through the larger lumen.

21
Q

common OG tube size

A

adults range from 36-40 French and 16-28 French for pediatrics.

22
Q

OG indications for use

A

Decompression of the stomach and small intestine

Evacuation of blood or secretions

Evacuation of ingested drugs or toxins

Instillation of medications and feedings

Obtaining of gastric contents for analysis

Administration of warm fluid to correct hypothermia

23
Q

Tracheotomy

A

a surgical incision into the trachea for the purpose of establishing an airway.. A tube is placed in the trachea just below the 2nd and 3rd tracheal ring, which bypasses the epiglottis

24
Q

Tracheostomy

A

a tracheal stoma or opening that resulted from a tracheotomy.

25
Q

Indications for a Tracheostomy

A
  1. Maintain a patent airway
    • Bypass an upper airway obstruction (foreign bodies, traumatic injuries, vocal cords paralysis, surgical edema, tumors, and burns.
  2. Facilitate removal of secretions
    • Severe bronchitis in a debilitated patient, neuromuscular disease, paralysis of chest muscles and diaphragm.
  3. Permit long-term positive pressure ventilation
    • Massive chest wall trauma, respiratory failure, high lesion spinal cord injury, prolonged coma, neuromuscular disease.
  4. Prevent aspiration of gastric contents
    • Prolonged unconsciousness.
  5. Lung/airway/breathing centre anomalies secondary to congenital defect.
  6. Improve patient comfort due to absence of endotracheal (ET) tube.
  7. Decrease work of breathing and increase volume entering the lungs by reducing anatomical dead space
26
Q

immediate complications of tracheostomy

A 
Hemorrhage  
Pneumothorax  
Subcutaneous and mediastinal emphysema  
Respiratory and cardiovascular collapse  
Dislodged tube
27
Q

late complications of tracheostomy

A

Airway obstruction

Infection (nosocomial pulmonary infection rate in patient with a trach is 50-60%, largely due to natural body defenses being bypassed by the trach tube; infection can be pulmonary stomal)

Aspiration (secretions, gastric contents)

Tracheal damage (progressive, fistula)

Dislodged tube

28
Q

Cleaning Inner Cannula and Changing Dressing

A
  1. Assemble equipment and prepare dressing tray.
  2. Remove the inner cannula from the trach tube.
  3. Immerse in cleaning solution.
  4. Remove used trach sponge and assess for secretions. Discard and assess the site.
  5. Clean tracheostomy site with a sterile Q-tip and normal saline
  6. Change the trach ties if they are soiled, or as per agency policy or order
  7. Using a trach brush, clean inside the inner cannula and remove secretions.
  8. Once all secretions are removed rinse the inner cannula well with normal saline. This is done by immersing the cannula in the basin of normal saline for 10 seconds.
  9. Reinsert inner cannula.
    Lock in place.
  10. Apply new trach sponge
29
Q

Cystic fibrosis

A

increases the amount of mucus present in the airway limiting airflow and reducing diffusion across the pulmonary capillary membrane

30
Q

Bronchopulmonary dysplasia

A

results from early oxygen administration to usually premature newborns and causes permanent changes in the cells

31
Q

A terminally ill patient has the following rights:

A

The right to know the truth

The right to confidentiality and privacy

The right to consent to treatment

The right to choose the place to die in the Time of death

The right to determine the disposition of his or her body

32
Q

A large bowel obstruction

Symptoms of large bowl obstruction include

A

usually results from a growth within the bowel rather than adhesions

changes in stool, abdominal distension and localized pain

33
Q

A small bowel obstruction

symptoms of small bowel obstruction

A

occurs with the small intestine becomes blocked improperly dissolved medication’s, food supplements or the actions of certain types of medication can all lead to bowel obstructions

include diffuse pain, nausea and vomiting containing faecal matter

34
Q

In susceptible patients a full bladder can lead to

A

dangerously high blood pressure which places the patient at risk for stroke this condition is termed autonomic dysreflexia

35
Q

Hemodialysis

A

Blood goes through machine and gets filtered and put back

36
Q

Fistula

A

surgical procedure that has linked an artery to a vein

37
Q

Synthetic graft

A

synthetic blood vessel between an artery and a vein

38
Q

Peritoneal Dialysis

A

stomach is filled with dialysis solution

the peritoneum allows waste products and extra fluid to pass from the patient’s blood into the dialysis solution

39
Q

a dialysis exchange

A

The process of draining and filling is called an exchange which takes approximately 30 to 40 minutes

40
Q

dwell time

A

This period of dialysis solution is in the abdomen is called the dwell time. A typical schedule has the patient perform four exchanges a day, with dwell times of 4 to 6 hour

41
Q

continuous ambulatory peritoneal dialysis (CAPD),

A

doesn’t require a machine. As the word ambulatory suggest, the patient may be able to walk around when the dialysis solution is in their abdomen

typically three or four exchanges during the day and one evening exchange with along overnight dwell time

42
Q

continuous cycler-assisted peritoneal dialysis (CCPD)

A

which requires a machine called a cycler to fill and drain the patient’s abdomen. The automatic cycler is to perform three to five exchanges during the night while the patient sleeps and the patient will begin one exchange with a dwell time that lasts the entire day

43
Q

precautions of dialysis

A

Sudden drop in blood pressure is not uncommon during or immediately after dialysis but it can lead to cardiac arrest

One consequence of renal impairment is the inability to excrete ingested potassium therefore patients are prone to developing hyperkalaemia

Air embolism

EMER 116 (7 decks)

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