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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
Q

***What are some of the uses for the catheter mentioned in the previous question?
(Central venous catheter
Venous access device
Hickman/Groshong)

A 
Administer chemotherapeutic and other drugs
Parenteral nutrition
Manage fluid volume
Blood analysis and transfusion
Monitor cardiac pressure
26
Q

***Where is the preferred location for a central venous line?

A

SVC approximately 2 to 3 cm above the right atrial junction

Hickman & Broviac

27
Q

***What are some of the common insertion sites for central venous lines?

A 
Subclavian vein
Internal jugular vein
Femoral vein
Antecubital area (PICC lines)
Basilic vein
Cephalic vein
28
Q

***What type of line is a Swan-Ganz catheter?

A

Pulmonary arterial or PA line

29
Q

***What is a pulmonary arterial line?

A

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
Q

***Who performs the insertion of a PICC line?

A

Radiologist
Nurse
Specially trained technologist

31
Q

***What are some of the uses of a PICC line?

A

Prolonged antibiotic treatment
Home health care for extended treatment
Chemotherapy
Nutrition

32
Q

PICC Line stand for

A

Peripherally Inserted Central Catheter

33
Q

***Where is PICC line inserted?

A

Into patient’s arm and advanced into a central
vein (Subclavian to SVC)
• Basilic, cephalic or median cubital veins

34
Q

What is an Implanted access device?

A

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
Q

***What type of needle is used to access an Implanted access device (port)?

A

Huber needle

36
Q

Implanted port

A

Frequent intravenous medications or transfusion
– Plastic, titanium or stainless steel
– Implanted into Subcutaneous tissue

37
Q

***Catheter from port inserted into

A

Subclavian or internal jugular vein

38
Q

Right Side Approach for Line Placement

A

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
Q

Left Side Approach for Line Placement

A

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
Q

What are the primary uses for a nasogastric tube?

A

Administration of medications
Gastric decompression
Removal of fluids from stomach after obstruction or trauma

41
Q

What is the most common NG tube?

A

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
Q

3 other types of NG tube are

A

Nutriflex tube
Moss Tube
Sengstaken-Blakemore (S-B)

43
Q

Nutriflex tube

A
  • Primarily for feeding

* Mercury-weighted tip

44
Q

Moss Tube

A

• 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
Q

Sengstaken-Blakemore (S-B)

A

• 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
Q

NE tube also called

A

Nasoenteric Feeding Tube
Entriflex or Dobhoff tube
• Narrow lumen tube

47
Q

What are some uses for the nasoenteric feeding tube?

A 
• Intestinal decompression
• Introduction of mercury after insertion
Feeding and hydration of patient
Contrast administration
Not used with SUCTION
48
Q

***Nasoenteric feeding tubes are………and more ……………. than NG tubes.

A

Thinner

Flexible

49
Q

NE tubes can stay in for

A

a longer period of time

50
Q

NE tubes are positioned @

A

the level of 3rd portion of duodenum

51
Q

3 Most common NE tubes are

A

Cantor: single-lumen
– Harris: single-lumen
– Miller: double-lumen

52
Q

What is a PEG tube?

A

Gastric feeding tube
Surgical creation of opening into stomach
Percutaneous Endoscopic Gastrostomy – most common type

53
Q

PEG tube placed

A

From inside of the stomach to external abdominal wall

54
Q

What is the purpose of PEG tube?

A

Feeding a patient who cannot tolerate oral intake of
food
• Temporary/permanent

55
Q

PEG tube is closed off after feeding with

A

clamp or plug-in adapter to prevent leakage of contents

– Tube is coiled and taped in place

56
Q

PEG is inserted through

A

small incision into stomach or jejunum
– Endoscopy procedure
– Surgery

57
Q

PEG tube is used for

A

long term nutrition

58
Q

Defecogram also called

A

Defecography
Evaluation proctography
Dynamic rectal exam

59
Q

Perform Defecogram

A

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
Q

Images acquired during Defecogram procedure

A

Lateral projection @ 1 to 2 images per second
(rapid sequence)
– Video recording may be done

61
Q

Images evaluate of Defecogram

A

Measurements of anorectal angle & angle between long

axes of anal canal & rectum

Hannah RAD III (25 decks)

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