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Hannah RAD III > Medical Devices PPT > Flashcards

Medical Devices PPT Flashcards

1
Q

What is another name for a chest tube?

A

Thoracostomy or Intrapleural Tube

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2
Q

Where is a chest tube inserted?

A

Fluid accumulates near lung base (5th to 6th intercostal space @ midaxillary)
Air rises to upper pleural space (2nd to 3rd intercostal @ midclavicle)

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3
Q

Purpose of a chest tube

A

Drain intrapleural space & mediastinum

– Fluid/air

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4
Q

***A chest tube is inserted to reestablish intrapleural pressure that may be caused by what various conditions?

A

Pneumothorax
Hemothorax
Pleural effusion
Empyema

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5
Q

What is Empyema?

A

Type of pleural effusion where fluid is affected

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6
Q

Negative pressure is disturbed

A

Lungs fail to expand or collapse

Tube is inserted to reestablish pressure

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7
Q

Chest tube attaches to

A

Watersealed drainage unit

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8
Q

Collects air/fluid to reestablish

A

the correct Intrapleural pressure & allows lungs to

expand

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9
Q

Tube remains below water level to

A

Maintain seal

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10
Q

Tube ends in a chamber containing

A

Sterile water or sterile saline

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11
Q

Patient inhales & air/fluid are drawn into

A

Dainage tube and ChamberInto

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12
Q

Various water-sealed systems are

A

Disposable

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13
Q

***Mediastinal drain (small chest tube)

A

After cardiac surgery
– Drains residual blood from Mediastinum to
prevent accumulation around Pericardium

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14
Q

2 Chest tubes

A

Y connector joins tubes near patient’s body and continues to drainage apparatus

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15
Q

How to Handling Chest Tubes

A

Keep tubing from pleural cavity to drainage chamber as straight at possible – prevent tension from being placed on tube
• Do not empty water-sealed chambers or raise them – it must remain below the patient’s chest @ all times
• Do not clamp chest tube
• If chamber is bubbling, notify patient’s nurse
immediately (indicates possible leak)
• Patient’s breathing changes or complains of chest pain, notify patient’s nurse immediately

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16
Q

CXR Images

A

Before and after insertion
– Proper insertion
• Verify tube can be removed
• Initial images to confirm lung expansion
• 2 hours after clamping to verify continued expansion
– After removal to confirm lung expansion

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17
Q

What is the purpose of an endotracheal tube (ETT)?

A

Mechanical ventilation or oxygen delivery
Upper airway obstruction
Impending gastric acid reflux or aspiration

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18
Q

Endotracheal tube (ETT) inserted

A

Through mouth into trachea (or through tracheostomy)
– After placed in trachea, cuff is inflated to keep airway open
– Establishes airway; prevents aspiration of foreign
objects

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19
Q

Where is the proper placement of the endotracheal tube?

A

5 to 7 cm superior to tracheal bifurcation (halfway between clavicles and carina {T5-T7}

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20
Q

CXR to determine

A

Proper placement

– 20% require repositioning

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21
Q

Atelectasis is

A

Collapsed lung

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22
Q

***If Endotracheal tube (ETT) tube is inserted too far

A

Enters the right bronchus causing a collapse of left lung or atelectasis

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23
Q

If Endotracheal tube (ETT) tube is too high

A

Air enters the stomach and regurgitation leads to aspiration pneumonia

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24
Q

What is the name of the catheter that is inserted into a large vein and has a variety of uses?

A

Central venous catheter
Venous access device
Hickman/Groshong (developer)

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25
***What are some of the uses for the catheter mentioned in the previous question? (Central venous catheter Venous access device Hickman/Groshong)
``` Administer chemotherapeutic and other drugs Parenteral nutrition Manage fluid volume Blood analysis and transfusion Monitor cardiac pressure ```
26
***Where is the preferred location for a central venous line?
SVC approximately 2 to 3 cm above the right atrial junction | Hickman & Broviac
27
***What are some of the common insertion sites for central venous lines?
``` Subclavian vein Internal jugular vein Femoral vein Antecubital area (PICC lines) Basilic vein Cephalic vein ```
28
***What type of line is a Swan-Ganz catheter?
Pulmonary arterial or PA line
29
***What is a pulmonary arterial line?
Single or multilumen CV line that contains a small electrode at distal end which is used to monitor pulmonary arterial pressure It enters through right internal jugular and ends in the right pulmonary artery
30
***Who performs the insertion of a PICC line?
Radiologist Nurse Specially trained technologist
31
***What are some of the uses of a PICC line?
Prolonged antibiotic treatment Home health care for extended treatment Chemotherapy Nutrition
32
PICC Line stand for
Peripherally Inserted Central Catheter
33
***Where is PICC line inserted?
Into patient’s arm and advanced into a central vein (Subclavian to SVC) • Basilic, cephalic or median cubital veins
34
What is an Implanted access device?
A device surgically implanted under patient’s skin in the chest wall or patient’s arm. Tip lies in SVC Used for drawing blood or administering medications/contrast
35
***What type of needle is used to access an Implanted access device (port)?
Huber needle
36
Implanted port
Frequent intravenous medications or transfusion – Plastic, titanium or stainless steel – Implanted into _Subcutaneous_ tissue
37
***Catheter from port inserted into
Subclavian or internal jugular vein
38
Right Side Approach for Line Placement
Follow course of subclavian vein in a lateromedial direction Right brachiocephalic vein – SVC to right atrium • Catheter is _Right_ of vertebral column • Does not cross _Midline___
39
Left Side Approach for Line Placement
Slightly longer catheter is required Advanced lateromedially to left subclavian vein to left brachiocephalic vein – Vein courses horizontally – Catheter crosses midline from left to right ending in SVC
40
What are the primary uses for a nasogastric tube?
Administration of medications Gastric decompression Removal of fluids from stomach after obstruction or trauma
41
What is the most common NG tube?
Levin tube: Single lumen with several holes near its tip Sump tube: double-lumen tube • Second opening is referred to as “_Pigtail_” – Blue extension off of proximal end of tube
42
3 other types of NG tube are
Nutriflex tube Moss Tube Sengstaken-Blakemore (S-B)
43
Nutriflex tube
* Primarily for feeding | * Mercury-weighted tip
44
Moss Tube
• Triple-lumen tube • One end has inflatable balloon to anchor in stomach; 2nd lumen is for aspiration of fluid; 3rd lumen is for duodenal feeding
45
Sengstaken-Blakemore (S-B)
• Triple-lumen tube • 2 lumens with balloons – Inflated for pressure on varices • 3rd lumen used for lavage and monitors hemorrhage – Pressures must be maintained @ all times – Requires nurse to be with patient @ all times – ICU patients
46
NE tube also called
Nasoenteric Feeding Tube Entriflex or Dobhoff tube • Narrow lumen tube
47
What are some uses for the nasoenteric feeding tube?
``` • Intestinal decompression • Introduction of mercury after insertion Feeding and hydration of patient Contrast administration Not used with SUCTION ```
48
***Nasoenteric feeding tubes are.........and more ................ than NG tubes.
Thinner | Flexible
49
NE tubes can stay in for
a longer period of time
50
NE tubes are positioned @
the level of 3rd portion of duodenum
51
3 Most common NE tubes are
Cantor: single-lumen – _Harris_: single-lumen – _Miller_: double-lumen
52
What is a PEG tube?
Gastric feeding tube Surgical creation of opening into stomach Percutaneous Endoscopic Gastrostomy – most common type
53
PEG tube placed
From inside of the stomach to external abdominal wall
54
What is the purpose of PEG tube?
Feeding a patient who cannot tolerate oral intake of food • Temporary/permanent
55
PEG tube is closed off after feeding with
clamp or plug-in adapter to prevent leakage of contents | – Tube is coiled and taped in place
56
PEG is inserted through
small incision into stomach or jejunum – Endoscopy procedure – Surgery
57
PEG tube is used for
long term nutrition
58
Defecogram also called
Defecography Evaluation proctography Dynamic rectal exam
59
Perform Defecogram
Defecation dysfunction • No patient prep • Instill barium directly into rectum using special injector • Patient seated laterally on a commercially available radiolucent toilet in front of fluoro unit
60
Images acquired during Defecogram procedure
Lateral projection @ 1 to 2 images per second (rapid sequence) – Video recording may be done
61
Images evaluate of Defecogram
Measurements of anorectal angle & angle between long | axes of anal canal & rectum

Hannah RAD III (25 decks)

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