post op equipment Flashcards
goal for incentive spirometer based on?
Age, height, and gender
- typical use 10x/hr
purpose of drains
prevent fluid and blood from accumulating in tissues and causing infection
- facilitate healing
open drain
drainage absorbed by a sponge
closed drain
drainage into a collection devise
active drain
drain attached to suction
passive drain
no suction attached to drain
what is a penrose drain
open, passive; soft rubber tube secured with safety pin; placed in a wound are to prevent the buildup of fluid
- 2” of drain poking out
- may be sutured
penrose drain typically seen in….
radical perineal prostatectomy (RPP)
thyroidectomy
abdominal surgeries
how often to check a penrose drain dressing
Q2H
Jackson Pratt drain (JP)
- AKA: “Davol” drain
- constant suction drainage devise
- flexible plastic tube that connects to an internal plastic drainage tube
- closed system (can be active or passive)
some uses for a JP drain
post op: breast, abdominal, thyroidectomies, lymph, spinal, etc.
bulb on a JP drain
compressed: active draining
not compressed: passive draining
how is a JP drain secured
sutures or steri-strips
when to stop use of a JP drain
- drs orders
- usually until less than 30mL in 24 hours
important thing about emptying a JP dain
note the amount
what is a hemovac
- closed active drain system
- similar to JP but circular and flat
- only works when compressed
- compressed to provide gentle suction
what is a T-tube
a tube placed in the common bile duct after a cholecystectomy that drains into a bile bag.
how long is a T tube left for
about 10 days
where is a T tube on the abdomen
RUQ
what to do before removing a T-tube
x-ray before removal to make sure no gallstones formed
4 major drain principles
- if the drain comes out, it stays out
- if no drainage, check tubing for kinks
- document I&O, site condition, and drainage
- should be gradually decreasing
drain removal considerations
- check orders
- pre-medicating for pain
- sutures present?
- release suction
- steady, even pull
- make sure removed drain is intact
- cover with dressing
how often to change a wound vac
about once a week
what is pico negative pressure wound therapy
- surgical incisions to help with healing
- like a wound vac but with no drainage chamber
- think more approximation
continuous bladder irrigation
- murphy drip
- to prevent blood clots
- three-way catheter
parts of the CBI three way catheter
irrigant in, urine out, balloon port
CBI capacity
3000-5000mL
nursing care for CBI
- keep extra irrigation bags at bedside
- empty cath bag frequently
- keep urine pink and without blood clots
- never stop without an order
settings on a PCA to compare to MAR
- basal rate
- PCA dose
- lockout time
how to calculate hourly limit
basal rate + maximum PCA doses/hr
capnography measures?
end tidal CO2 of exhaled air
normal range of capnography
35-45mmHg
what is an on-q pump
small disposable pump that delivers local anesthesia after a surgery
on-Q pump assessment
- correct med/ concentration
- clamp open
- tubing not kinked
- do NOT squeeze the ball
TENS
- transcutaneous electrical nerve stimulation
- low intensity/ high frequency electrical current to relieve pain
CPM
continuous passive movement machine
assess CPM for…
- angles of flexion and extension
- times
what are SCDs and what do they do
sequential compression devises
- VTE prophylaxis
binders what to assess
circulation and comfort
what are binders used for
- splinting abdominal incisions post-op
- reducing edema
- holding pressure
