PCM 2 (Unit 2) Equipment, Lines, and Tubes Flashcards
Oxygen Therapy Delivery
What is the Function of the O2 Nasal Cannula?
This is used to administer oxygen at various levels
- This is administered via the nose, and the tubing may be connected to an O2 line from the wall or a portable oxygen tank
Oxygen Therapy Delivery
With the O2 Nasal Cannula, what are some precautions and what Diagnosis commonly uses this?
Precautions:
- Monitor lines during mobility so as not to pull from the face, wall or tank. Ensure proper length of extension line and educate not to trip or tangle the lines
- Monitor vital signs SpO2 at rest and with activity. Observe for kinks and remove if present, inspect skiin on face where line is placed
Diagnosis commonly encounted:
- Cardiopulmonary, respiratory dysfunction
Oxygen Therapy Delivery
What is the function of an Open Face Tent?
- This provides humidifed, supplemental O2 mixed with room air, also used to provide nebulized medication
- This is placed over the mouth and nose
Oxygen Therapy Delivery
With the Open Face Tent, what are some precautions and what Diagnosis commonly uses this?
Precautions:
- Moisture may collect in the mask and should be drained prior to mobilization. Cumbersome and may shift during mobilization, make sure to maintain placement. Monitor lines during mobility so as not to pull form the face, wall or tank. Ensure proper length of extension line and educate not to trip or tangle the lines.
- Monitor vital signs SpO2 at rest and with activity. Observe for kinks and remove if present, inspect skin on face where line is placed
Diagnosis commonly encounted:
- Cardiopulmonary, respiratory dysfunction
Oxygen Therapy Delivery
What is the Function of the Closed Face Mask?
- This delivers supplemental oxygen missed with room air
- This is placed over the nose and mouth
Oxygen Therapy Delivery
With the Closed Face Mask, what the precautions and what diagosis commonly use this?
Precautions:
- Can interfere with coughing, talking, eating, and drinking. They may cause irritation of the skin. Keep the mask in place during therapy. monitor lines during mobility so as not to pull form the face, wall or tank. Ensure proper length of extension line and educate not to trip or tangle the lines. Monitor vital signs SpO2 at rest and with activity. Observe for kinks and remove if present, inspect skin on face where line is placed.
Diagnosis commonly encounted:
- Cardiopulmonary, respiratory dysfunction
Oxygen Therapy Delivery
What is the Function of the Transtracheal Oxygen Catheter?
- This is for long term O2 supplementation of oxygen mixed with room air
- This is placed in the trachea
Oxygen Therapy Delivery
With the Transtracheal Oxygen Catheter, what are the precautions and what diagnosis commonly uses this?
Precautions
- Monitor for hygiene and wound infection. monitor lines during mobility so as not to pull form the face, wall or tank. Ensure proper length of extension line and educate not to trip or tangle the lines. Monitor vital signs SpO2 at rest and with activity. Observe for kinks and remove if present, inspect skin on face where line is placed.
Diagnosis commonly encounted:
- Cardiopulmonary, respiratory dysfunction
Oxygen Therapy Delivery
What is the function of the Tracheostomy Collar?
- An incision into the trachea is made to bypass the nasal and mouth apparatus for breathing and provide a more direct flow of oxygen
- This is place in the trachea; a trach tent will be placed over the tracheostomy tube to administer O2 from the tank of the wall
Oxygen Therapy Delivery
With the Tracheostomy Collar, what are the precautions and what diagnosis commonly uses this?
Precautions:
- Moisture may collect in the mask and should be drained prior to mobilization. Cumbersome and may shift during mobilization. Do not kink or disconnect during mobility. Do not apply pressure to the site during transfers, do not remove
Diagnosis Commonly Encountered
- Cardiopulmonary, respiratory dysfunction
Oxygen Therapy Delivery
What is the Function of Endotracheal and Tracheostomy Tubes?
- This machine uses positive pressure to propel gas/air into the patients lungs
- This ventilation can be administered through an endotracheal tube (or ET tube) which is inserted orally through the mouth into the trache, or through a trachestomy which is surgically performed to create an incision directly into the trachea
Oxygen Therapy Delivery
With the Endotracheal and Tracheostomy Tubes, what are the precautions and what diagnosis commonly uses this?
Precautions:
- Ensure tubing is secured and not obstructed, communicate with the interprofessional team for initiating mobility as well as getting their assistance during mobility from the RN and respiratory therapist, communication and monitoring the patient and their responses to activity, ensure adequate length of tubing as well as organizing the start position for the activity to be performed.
Diagnosis commonly encountered:
- Patients with disorders of consciousness, and those with diseases that create impaired control of respiration and interfere with gas exchange into the lungs may require use of mechanical ventilation.
Oxygen Therapy Delivery
What is the Function of a Non-rebreather mask and a Partical Non-rebreather mask?
- Non-rebreather provides highest amount of supplemental oxygen with a one way valve
- Partial rebreather is a two way valve supplying oxygen and room air
- These are placed over the nose and mouth
Oxygen Therapy Delivery
With the Non-rebreather mask and a Partical Non-rebreather mask, what are the precautions and what diagnosis commonly uses this?
Precautions:
- If pt is on non-rebreather, PT is usually deferred. For the partial rebreather, be sure the reservoir bag remains partially full upon inspiration.
Diagnosis commonly encountered
- Respiratory dysfunction
Oxygen Therapy Delivery
What is the Function of an Air Entrainment Mask (Vent-Mask)?
- Using a color code system, this provides a specific concentration of supplemental oxygen
- This is placed over the nose and mouth
Oxygen Therapy Delivery
With the Air Entrainment Mask (Vent-mask), what are the precautions and what diagnosis commonly uses this?
Precautions:
- If humidification is used, observe the line for moisture. Educate patient about importance of keeping mask in place. monitor lines during mobility so as not to pull from the face, wall or tank. Ensure proper length of extension line and educate not to trip or tangle the lines. Monitor vital signs SpO2 at rest and with activity. Observe for kinks and remove if present, inspect skin on face where line is placed.
Diagnosis commonly encountered
- Respiratory dysfunction
Oxygen Therapy Delivery
What is the Function of Bi-level positive airway pressure (BiPAP)?
- This is a pressure supported non-invasive ventilation
- This is placed over the nose and mouth secured with straps
Oxygen Therapy Delivery
With Bi-level positive airway pressure (BiPAP), what are the precautions and what diagnosis commonly uses this?
Precautions
- Check skin integrity over the bridge of the nose. Check orders for alternative deliveries of O2 supplementation when mobilizing as it is not common to mobilize with BiPap running.It can however be placed on portable pole to mobilize if needed. Ensure adequate line, no dislodging, and monitoring of O2 saturation.
Diagnosis commonly encountered
- Cardiopulmonary, respiratory dysfunction
Hemodynamic Monitoring
What is the Function of the Dynamap and BP Cuff?
- This monitors BP
- This is placed on the proximal UE (preferred), can also be placed on forearm or distal leg/calve
Hemodynamic Monitoring
With the Dynamap and BP Cuff, what are the precautions and what diagnosis commonly uses this?
Precautions:
- Monitor BP before, during, and after treatment. Ensure line does not tangle and is securely fastened to the cuff from the machine for proper inflation
Diagnosis commonly encountered
- General populations
Hemodynamic Monitoring
What is the Function of Telemetry and Cardiac Monitor/Leads?
- Wall mounted monitors, portible telemetry units to monitor HR and rhythm
- This is placed on the chest
Hemodynamic Monitoring
With Telemetry and Cardiac Monitor/Leads, what are the precautions and what diagnosis commonly uses this?
Precautions
- If abnormal reading presents, check placement of leads and make sure they are secured. If abnormal reading persists, seek RN assistance. Do not disconnect.
Diagnosis commonly encountered
- Cardiopulmonary
Hemodynamic Monitoring
What is the Function of the Pulse Oximetry?
- Basic monitoring of HR and SpO2 vital signs
- This is placed on the finger, forehead, earlobe or toe
Hemodynamic Monitoring
With Pulse Oximetry, what are the precautions and what diagnosis commonly uses this?
Precautions
- Do not detach this monitor during mobility, as it is important to monitor vital sign response during functional activity and mobility
Diagnosis commonly encountered
- Particularly those presenting with cardiopulmonary pathologies, neurologic, and multi trauma
Hemodynamic Monitoring
What is the Function of Arterial Line?
- Continuous measure of BP, and allow for repeated blood samples (such as blood gases) while avoiding repeated needle punctures
- This is found in many available artery, most common placed A line is the Radial Artery
Hemodynamic Monitoring
With Arterial Lines, what are the precautions and what diagnosis commonly uses this?
Precautions
Exercise may be performed, but strong precautions must be taken to avoid dislodging or occluding the line. ROM should be limited near the line placement. If dislodged, immediate secure pressure must be placed on the site, and the nurse must be alerted through use of the call bell. Most importantly, do not panic, as you do mot want to alarm your patient.
Diagnosis commonly encountered
- Cardiopulmonary, neurologic injury, patients needing close cardiac monitoring
Hemodynamic Monitoring
What is the Function of the Central Venous Catheter?
This is a long, flexible tube your provider inserts into a vein in your neck, chest, arm or groin. It leads to your vena cava, a large vein that empties into your heart. A CVC helps you receive drugs, fluids or blood for emergency or long-term treatment. It also helps with blood draws
Diagnosis commonly encountered:
Cardiopulmonary, respiratory dysfunction
Hemodynamic Monitoring
With the Pulmonary Artery Catheter (Swan Ganz Catheter), what are the precautions and what diagnosis commonly uses this?
Precautions
- Exercise may be performed with this catheter, but may need to be limited based on location of insertion. If placed in the Subclavian vein, shoulder flexion needs to be avoided, and overall shoulder movement limited. The femoral vein requires less than 30 degrees of hip flexion and limited hip abduction in order to maintain an accurate reading. Timelines of inactivity are often ordered prior to initiating a patient OOB immediately post surgical placement.
Diagnosis commonly encountered
- Cardiopulmonary, respiratory dysfunction
Hemodynamic Monitoring
What is the Function of the Intracranial Pressure Monitor?
- A line that monitors the pressure exerted on the skill by the brain tissue, blood and/or CSF
- This is surgically placed through a hole drilled into the skull to access the lateral ventricle of the brain
Hemodynamic Monitoring
With the Intracranial Pressure Monitor, what are the precautions and what diagnosis commonly uses this?
Precautions
- Limited physical mobility can be performed when this monitoring is in place. It relies on a transducer that is position dependent and must require repositioning of this transducer is the patient is moved form supine to sitting or standing in order to ensure accurate readings. Avoid activities that will increase ICP such as Valsalva or isometric exercise. Limit neck flexion, limit hip flexion greater than 90 degrees, laying prone or laying below the level of 15 degrees below the horizontal. Ensure proper monitoring of the line so as to avoid disruption, dislodging or malplacement.
Diagnosis commonly encountered
- Closed head injury, cerebral hemmorahge, brain tumor or overproduction of cerebrospinal fluid
Hemodynamic Monitoring
What is the Function of the External Ventricular Device?
- This is inserted surgically into the brain to monitor intracranial Pressure. This also drains CSF and blood that is in excess from the ventricles in the brain to reduce swelling and help attain a more normal ICP reading
- This is placed in the brain and ventricles; Nursing is responsible for managing the EVD device once in place. The patients head must be aligned with the transducer, which must be leveled at the external meatus of the ear
Hemodynamic Monitoring
With the External Ventricular Device, what are the precautions and what diagnosis commonly uses this?
Precautions
- With specific orders from the physician indicating the patient is safe to have the EVD clamped and realigned for mobility then allows us to help improve functional mobility in these patients. Communication with nursing is essential in that the nurse will be the one to clamp and unclamp the drain, as well as reposition during mobility and at termination when you are finished. While working with a patient with an EVD, the doctors may begin trials where the drain remains clamped. It is important to know when this is occurring and to monitor behavior and cognition for abnormal signs, such as irritability, confusion or even HA and vomiting. If this were to occur while the EVD is clamped, it may signify the patient is not ready to have the catheter removed.
Diagnosis commonly encountered
- Patients with acquired brain injury having had an intracranial or subarachnoid hemorrhage, a traumatic brain injury, meningitis, hydrocephalus, or tumor
