Patient Intervention

Question 1

Hypoxemia

Answer 1

Inadequate level of oxygen in arterial blood.

eg: PaO2 is < 60mm Hg/ Hb saturation is < 90%

Question 2

Hypercapnia

Answer 2

CO2 retained in arterial blood

Question 3

Hazards of oxygen administration

Answer 3

Mild oxygen toxicity : reversible tracheobronchitis
Severe oxygen toxicity: irreversible parenchymal lung injury

Question 4

What happens when excessive amount of oxygen is present in the blood of patient with COPD?

Answer 4

*Depress the respiratory drive and pt may stop breathing.
*Because they have chemoreceptors that does not respond respond to the stimuli of CO2
* Their respiratory stimulus is hypoxemia.

Question 5

Oxygen delivery systems

Answer 5

wall outlet: 60 to 80 lb per square inch
Full tank: 2000 lb per square inch

Question 6

Flow rate of oxygen through Nasal Cannula

Answer 6

Adults: 1-4 LPM
Children: 1/4 to 1/2 LPM

Question 7

Flow rate of Nasal catheter

Answer 7

1-5 LPM

Question 8

Flow rate of oxygen Face mask

Answer 8

at least 5 LPM
*Non rebreathing mask - 100% oxygen
*Partial rebreathing mask - 60% - 90%
* Venturi mask - 24% - 50% by mixing room air and O2
* Aerosol Mask - 60% - 80% O2 mixed with water particles

Question 9

Types of Nasogastric tubes

Answer 9

1. Levin
2. Sump
3. Nutriflex
4. moss
5. Sengstaken- Blakemore

Question 10

Levin tube

Answer 10

Single lumen, plastic tubes passed through the nose into the stomach.
Use: gastric decompression

Question 11

Sump tube

Answer 11

2 Lumen, Radiopaque tube with a plug pigtail that lets airflow to the stomach
Use: Drain fluid from the stomach

Question 12

Nutriflex

Answer 12

1 lumen, mercury weighted tip; gastric secretion activated lubricant.
Use: Feeding

Question 13

Moss tube

Answer 13

3 lumen
one has inflatable balloon to anchor it in the stomach;
second lumen is used for aspiration of fluids;
third lumen for duodenal feeding.

Question 14

Sengstaken- Blakemore

Answer 14

Thick catheter with two lumens of balloons to exert pressure on the esophageal varices. Third lumen is used for lavage and to monitor hemorrhage.

Question 15

Types of NE Tubes

Answer 15

1. Cantor
2. Harris
3. Miller-Abbott

Question 15

Cantor tube

Answer 15

Single lumen; Long tube with a small mercury-filled bag at the end; contains drainage holes for aspiration.
Use: relieves obstruction in the small intestine.

Question 16

Harris tube

Answer 16

Single lumen
Mercury weighted tube passed through the nose and carried through digestive tract by gravity.
Use: Gastric & intestinal decompression

Question 17

Miller- Abbott tube

Answer 17

2 lumen; radiopaque tube.
Long small-caliber catheter; one is perforated metal tip and other has a collapsible balloon.
Use: Decompression

Question 18

Gastrostomy tube

Answer 18

• A tube placed through surgical opening from inside of the stomach to the abdominal wall.
• Chances of infection; use sterile gloves if contact with open area is needed.

Question 19

Central Venous Catheter(CVC)

Answer 19

-Used in patients with long-term meds administration, blood transfusion, hyperosmolar solutions or Total Parental solution(TPN).
-Also for measuring Central venous pressure(CVP)
-Placed at Brachiocephalic vein at the junction of SVC or at SVC itself.
- placement visualized with mobile radiography or C-arm fluoro at the time of insertion.
- The CVC line should be just medial to the anterior border of 1st rib.

Question 20

Large gauge catheter

Answer 20

Inserted to large peripheral vein in the arm.
- Parenteral solution with a combination of lipid emulsion and amino acid is administered

Question 21

Total parenteral nutrition(TPN)

Answer 21

• Delivered through Central vein
  -TPN is hyperosmotic; so would damage the intima of peripheral vein.
• Fluid imbalance occurs if TPN is administered too rapidly; so administration is controlled by pump.

Question 22

Types of central venous catheters

Answer 22

Tunnel type:-
1. Hickman catheter
2. Broviac Catheter
Others:-
3. Peripherally inserted central catheter(PICC)
4. Groshong catheter

Question 23

Indications for suctioning

Answer 23

1. Profuse vomiting in a patient who cannot change position voluntarily.
2. Audible rattling or gurgling sound from pt’s throat
3. signs of respiratory distress

Question 24

contraindication for suctioning

Answer 24

Head and facial injuries
bleeding esophageal varices
nasal deformities
trauma
cerebral aneurysms
tight wheezing
bronchospasm
croup

Question 25

Tissue drains

Answer 25

Placed near wounds or operative sites where drainage is expected.

Question 26

Types of tissue drains

Answer 26

1. Penrose: secured with safety pin to avoid slipping to wound. drains to surgical dressing.
2. Jackson-Pratt and Hemovac catheters maintain constant, low negative pressure.
3. ConstatVac is sued in total knee or hip replacement, to decrease Hematoma