Quiz 3 Flashcards
The study of distribution and determinants of disease and injuries in human populations; cause and effect, patterns of distribution of disease
Epidemiology
The reproduction of an infectious microorganism, but there is no interaction between the body and microorganisms that would result in a detectable immune response
Colonization
Person who is colonized but not ill/no symptoms
Carrier
Ability of an infectious agent to cause clinical disease
Pathogenicity
The severity of a clinical disease, morbidity, etc.
Virulence
6 elements needed to transmit infection
Infectious agent
Reservoir/environment in which the pathogenic microbes can live and multiply
Portal from which to exit the reservoir
Means of transmission
Portal of entry into new host; ex: inhale, swallowing, injected, etc.
Susceptible new host
Something that infiltrates another living thing
Infectious agent
Any person, animal, plant, soil, or substance in which an infectious agent normally lives and multiples
Reservoir/environment
Site through which microorganisms exit/enter the susceptible host and cause disease/infection; ex: mouth, nose, urinary tract, etc.
Portal
Infectious agent moves from source to host
Transmission
2 types of transmission
Direct
Indirect
Disease causing microorganisms pass from actual contact with the infected individual; ex: someone sneezes on you
Direct transmission
Susceptible person is infected from contact with a contaminated surface/object; ex: needle stick
Indirect transmission
Minute, single-cell organism with no nucleus; contains RNA and DNA
Can adapt
Bacteria
3 classifications of bacteria based on shape/appearance
Cocci
Bacilli
Spirilla
Cocci
Spherical
Bacilli
Oblong
Spirilla
Spiral
3 classifications of bacteria based on groups
Diplococci
Streptococci
Staphylococci
Groups of two
Diplococci
Streptococci
Chains
Irregular clusters, hanging grape-like bunches
Staphylococci
4 examples of bacteria
Diphtheria
Tuberculosis (TB)
Streptococcal infections
Chlamydia STD, etc.
Some have both yeast and mold characteristics Usually reproduce by budding/spores Thrive in dark, damp areas Can be harder to treat Ex: thrush, vulvovaginitis, etc.
Fungi
Vulvovaginitis
Yeast infection
2 forms of fungi
Yeast
Mold
Single cell fungi
Yeast
Miniature cell fungi
Mold
Live on or in other organisms at expense of host
Parasites
2 types of parasites
Protozoa
Helminths
More complex single-cell microorganisms, move by cilia action of flagella
Usually in GI tract in people
Ex: amebiasis, malaria from mosquitos, etc.
Protozoa
Infection of intestines by amoeba, usually dysentery from food or drink
Amebiasis
Parasitic worms that commonly affect intestinal tract; some can bee seen with naked eye
Ex: ringworm, tapeworm, pinworm, etc.
Helminths
Minute microorganisms that cannot be visualized by normal microscope, smallest microorganism to infect man
DNA or RNA
Attack host cell, invades and reproduces, and lies dormant or spreads
Once outside body = die immediately in dry form, wet form = die when exposed to heat, and in blood at 4°C = live a couple weeks
Ex: influenza, common cold, mumps, measles, AIDS/HIV, hepatitis A, B, and C, etc.
Viruses
4 microorganisms
Bacteria
Fungi
Parasites
Viruses
4 stages in the process of infection
Incubation period
Prodromal
Disease period
Convalescence period
Pathogen enters body and microbes start reproducing; disease process beginning
Incubation period
More specific symptoms of disease starting, microorganisms increase, and disease is highly infectious
Prodromal
Signs and symptoms reach full extent, when disease is most communicable
Disease period
Symptoms diminish and disappear, can go latent and come back again; ex: herpes, malaria, TB, gonorrhea, etc.
Convalescence period
2 tiers of precautions from CDC (1996)
Tier 1: standard precautions
Tier 2: transmission based precautions
Treat every patient as though they’re infected; use all the time, regardless of diagnosis
Refers to blood, open wounds, secretions (not sweat)/body fluids, intact skin/abrasions, mucous membranes, etc.
Standard precautions
Restrictions used when called for; ex: TB, GI, etc.
Transmission based precautions
3 types of disease transmission by government and 2 more (5 total)
Air: government Droplet: government Contact: government Common vehicle Vector-borne (ex: mosquito)
5 recommended vaccines for health care workers
Hepatitis B Influenza Varicella/chickenpox Pertussis, tetanus, and diphtheria Measles, mumps, and rubella (MMR)
5 transmission routes
Contact Droplet Common vehicle Airborne Vectorborne
Most common transmission route, direct or indirect
Contact
Rapid transfer of infectious agent through air over short distance; ex: sneeze
Droplet
Inanimate object involved in transmission of disease; ex: food, water, medicines, equipment, supplies, etc.
Fomite
Common vehicle
Infectious agent disseminated through air over a long distance, 6 feet to miles away
Airborne
Vector transports infectious agent to host; ex: fly, mosquito, etc.
Vectorborne
Animal that carries and transmits a pathogen capable of causing disease
Vector
Needle sticks account for ___% of job-related acquired HIV; never __________
84%, never recap
8 techniques for infection control
Handwashing proper/best way to prevent disease; up to 40-60 seconds with aseptic technique Dress for the workplace: no jewelry, long or fake nails, etc. Hair short or pulled back Gloves Eye protection Laundry Cleaning and proper waste disposal Disinfection
Condition free from germs
Asceptic
Process that reduces microbial life forms
Process of cleaning, especially with a chemical, in order to destroy bacteria
Disinfection/-ants
10 parts of standard precautions
Hand hygiene Gloves Mask, eye protection, and face shield Gown Needlestick safety Patient care equipment Environmental control Linen Occupation health and bloodborne pathogens Respiratory hygiene/cough etiquette
6 isolation techniques used when a patient is known to have a disease that is contagious
Drainage-secretion precautions Enteric precautions Acid-fast bacillus (AFB) isolation Respiratory isolation Contact isolation Strict isolation
Prevent infections that are transmitted by direct or indirect contact with purulent patient material, drainage, or secretions from an infected site on the body such as abscesses, wound infections, and burns; ex: MRSA
Gown, gloves, dressings bagged in proper containers, 3 minute hand scrubbing for asepsis, separate trash (incinerate infected object)
Drainage-secretion precautions
Prevent infections that are transmitted by direct or indirect contact with fecal material
Bowel, colon, etc.
Dysentery, cholera, etc.
Private room/bathroom, gowns, and gloves
Enteric precautions
Help with privacy, used with pulmonary TB who currently have a positive sputum culture for acid fast bacilli or a chest x-ray that reflects active TB (airborne)
Fitted mask, gowns if gross contamination, gloves, and private room with special ventilation closed door
Acid-fast bacillus (AFB) isolation
Isolation technique when spread by droplet contact as patient talks, coughs, or sneezes
Meningitis, flu, measles, mumps, etc.
Private room, masks, gowns, and gloves
Respiratory isolation
Used for diseases spread by close or direct contact, present microbes
Indirect: infected person touches object or not infected person, fomite
Acute respiratory infection pneumonia, etc/.
Masks, gowns, gloves, and private room
Contact isolation
Used for patients with diseases transported by airborne or contact route, highly infectious and spread is hard to control
Combination of protective and reverse isolation
Pharyngeal diphtheria (throat), plaque, chickenpox, etc.
Negative pressure room, mask, gown, gloves, hand washing and decontamination of items, and private room or with patient who has disease
Strict isolation
Isolation for immunocompromised patient
Negative pressure room
Reverse isolation
Process that destroys all microbial life forms including resistant spores, done by physical or chemical process
Sterilization
3 levels of disinfectants
High-level disinfection (HLD)
Intermediate-level disinfection
Low-level disinfection
Eliminates all microbial forms when there’s a high level of bacterial spores, ex: anthrax
High-level disinfection (HLD)
Kills TB bacteria, most viruses, fungi, but not bacterial spores
Intermediate-level disinfection
Sanitation; activates most bacteria, some viruses, and fungi, doesn’t work against TB or bacterial spores
Low-level disinfection
Antimicrobial substance on skin surface
Antiseptic
4 vital/cardinal signs
Body temperature
Pulse
Respiration
Blood pressure (BP)
Brain can’t survive/function for ___-___ minutes without oxygen
4-5 minutes
Result from metabolic activity must be stable in order for the body’s cellular and enzymatic activity to remain efficient
Temperature
Fever leads to increased pulse and respiration, general discomfort, achiness, flush, dry skin that feels hot, chills, loss of appetite, etc.
Pyrexia
Excessively high temperature of 105.8°F or 41°C
Hyperpyrexic
Temperature less than 34°C, death
Hypopyrexic
___-___°F for open heart surgery
92-92.5°F
Celsius (C) to fahrenheit (F) and fahrenheit to celsius conversion
C = (F-32)5/9 F = (9/5)C + 32
Average temperature and variance, 3 months to 3 years, and 5 years to 13 years
Average and variance: 98.6°F or 37°C, most people vary by 0.5-1°
3 months to 3 years: 99-99.7°F
5 years to 13 years: 97.8-98.6°F
5 methods for temperature taking
Oral Axillary Rectal Tympanic Temporal
Average oral (time), axillary (time), rectal temperature
Oral: 37°C or 98.6°F, 3-5 minutes
Axillary: 36.4-36.7°C or 97.6-96°F; 5-10 minutes, not as accurate
Rectal: 37.5°C or 99.6°F
Most accurate temperature taking method in pelvic viscera
Rectal
Number of heart beats
Pulse
Normal pulse for men and women at rest, infants, and children 4-10 years old
Men and women at rest: 60-90 beats/minute
Infants: 120 bpm
Children 4-10 years old: 90-100 bpm
Fast/rapid heartbeat over 100 bpm
Tachycardia
Heartbeat under 60 bpm
Bradycardia
Most accurate point to get pulse for infants/kids
At apex of heart
Apical
9 pulse points
Apical Radial Carotid Femoral Popliteal Temporal Dorsals Post-tibial artery pulse Brachial artery pulse
Purpose is to exchange oxygen and carbon dioxide (CO2) between the environment and the circulating blood
Look for quality of breath and symmetrical rise and fall of chest
Respiration
Normal respiration
12-20 breaths per minute
______ blood has oxygen; _______ lack oxygen and has carbon dioxide but _______ vein has oxygen
Arterial
Venous
Pulmonary
Amount of blood flow ejected from the left ventricle of the heart during systole and the amount of resistance the blood meets due to systemic vascular resistance, volume to resistance
Blood loss due to hemorrhage = lower
Generally lower in morning, men’s usually slightly higher
Blood pressure (BP)
Normal, pre-hypertension, and stage 1 and 2 hypertension BP
Normal: less than 120/less than 80 mmHg
Pre: 120-139/80-89 mmHg
1: 140-159/90-99 mmHg
2: 160 or more/100 or more mmHg
Difference between systolic and diastolic pressure
Pulse pressure
Normal systolic and diastolic pressure
Systolic: 110-140 mmHg, 120 or less
Diastolic: 60-80 mmHg
BP when the heart is contracting, maximum arterial pressure
Highest part reached, active/beating portion
Top number over diastolic
Systolic
Minimum arterial pressure during relaxation and dilation of ventricles of heart when they fill with blood; resting, lowest point
Minimum pressure exerted at arterial walls
Bottom number under systolic
Diastolic
Volume of blood pumped from left ventricle per beat; 120/80 = 40
Stroke volume (SV)
3 pieces of equipment for BP
Sphygmomanometer
BP cuff
Stethoscope
Mercury more _______, digital more _______
Accurate, common
Helps patient who isn’t getting enough oxygen
The effectiveness of pulmonary function, the lungs ability to exchange oxygen and carbon dioxide efficiently, is most accurately measured by laboratory testing of arterial blood for the concentrations of oxygen, carbon dioxide, bicarbonate, acidity, and the saturation of hemoglobin with oxygen
Oxygen therapy
Using light, measures the proportion of oxygenated hemoglobin in blood in pulsating vessels, especially the capillaries of finger or ear
Pulse oximeter (ox)
5 methods of oxygen therapy delivery
Nasal cannula Nasal catheter Face mask Nonrebreathing mask Oxygen tent
Amount of oxygen delivered with nasal cannula (adults, kids, and percent oxygen), catheter, face mask, and nonrebreathing mask
Cannula: 1-6 liters (L)/min adults, 1/4-1/2 L/min; 21-60%
Catheter: 1-6 L/min
Face mask: no less than 5 L/min, shorter time periods
Nonrebreathing mask: up to 100% oxygen by preventing CO2 from getting back into system
French-tipped catheter in pharynx, can get stomach distension if misplaced
Nasal catheter
Oxygen therapy for kids, preemies because lungs are last organs to develop in kids
Oxygen tent
___% oxygen in air
21%
2 hazards of oxygen administration
Fire: avoid sparks or flames
Parenchymal lung damage if patient goes on 100% all the time, want to use lowest level possible; short-term (bronchitis, etc.) may be reversible
Scale of 3-15 helps identify patient’s level of consciousness
7 or less means danger and if this happens, notify doctor and take patient to ER if necessary but never leave patient
Glasgow coma scale
On their own
Spontaneously
Physiological reaction due to sickness/illness, trauma, high stress emotional situation/disturbance, etc.; usually seen in young or elderly and can occur quickly
Shock
7 shock symptoms
Decreased temperature Weak pulse Rapid heartbeat Shallow respirations Hypotension Cyanosis Increased thirst
Sign of respiratory distress; bluish discoloration around mouth, gums, nailbeds, earlobes, etc.
Skin turns blue/purple due to lack of oxygenated blood; usually seen in extremities, nail beds, etc.
Cyanosis
Shock gets worse if not taken care of
Shock continuum
3 stages of shock continuum
Compensatory
Progressive
Irreversible
First stage of shock, body’s homeostatic mechanisms attempt to maintain CO2, BP, and tissue perfusion
Compensatory stage
Compensatory mechanisms begin failing to meet tissue metabolic needs, and the shock cycle is perpetuated/gets worse
Progressive stage
5 symptoms of the compensatory stage of shock continuum
Cold and clammy skin Decreased urine output Increased respirations and anxiety, may begin to be uncooperative Hypoactive bowel sounds Normal BP
7 symptoms of the progressive stage of shock continuum
BP falls
Rapid and shallow respirations
Acute respiration distress syndrome/shock lung
Tachycardia results; increased heart rate may be 150 bpm
Chest pain (CP)
Mental status changes beginning with subtle behavior alterations such as confusion with progression to lethargy and loss of consciousness
Renal, hepatic, GI, and hematologic problems
Shock becomes unresponsive to therapy; causes of shock can’t be fixed, organs fail, and death occurs
Irreversible stage
3 symptoms of the irreversible stage of shock continuum
BP remains low
Renal and liver failure result
Release of necrotic tissue toxins (causes necrosis of tissue) and an overwhelming lactic acidosis
Severe pulmonary edema results from leakage of fluid from the pulmonary capillaries
Acute respiration distress syndrome/shock lung
Buildup of lactate in body, resulting in excessively low pH in bloodstream; blood becomes more acidic
Lactic acidosis
Shock caused by abnormally low volume of circulating blood in the body, blood/fluid loss
15-20% decrease or by a loss of 750-1300 mL of fluid
Signs and symptoms may be placed into classes of I-IV
Restlessness, thirst, cold, clammy skin, sweating, cyanotic lips and nails, rapid respirations, systolic pressure less than 60-90 mmHg, anuria, and cardiac and respiratory failure will follow
Notify physician, make sure patient can breath, have emergency cart present, be ready to give oxygen, don’t leave patient, don’t give fluids unless doctor says to because examinations to see cause need empty stomach, etc.
Hypovolemic shock
Absence of urine
Anuria
Blood loss of 15%
Class I hypovolemic shock
5 symptoms of class I hypovolemic shock
BP within normal limits Heart rate less than 100 bpm Slightly anxious patient Respiration range from 14-20 per minute Urine output within normal limits
Blood loss of 15-30%
Class II hypovolemic shock
5 symptoms of class II hypovolemic shock
BP within normal limits
Heart rate greater than 100 bpm (exceeds normal limits)
Increasingly anxious patient
Respiration range from 20-30 per minute (exceeds normal limits)
Urine output decreases
Blood loss of 30-40%
Class III hypovolemic shock
5 symptoms of class III hypovolemic shock
BP decreases to below normal limits Heart rate greater than 120 bpm Anxious and confused patient Respiration increases up to 30-40 per minute Urine output is greatly decreased
Blood loss of more than 40%
Class IV hypovolemic shock
5 symptoms of class IV hypovolemic shock
Systolic BP decreases from 90 to 60 mmHg
Heart rate greater than 140 bpm with weak and thready pulse (hard to find because heart beating so fast to get fluid to body and heart overworking itself)
Confused and lethargic patient
Respiration greater than 40 per minute
Urine output further diminishes or ceases
Caused by a failure of the heart to pump an adequate amount of blood to the vital organs
Usually in patients with myocardial infarction (MI), cardiac tamponade, or pulmonary embolus
Chest pain, restlessness, decreasing BP, cyanosis, irregular and slow pulse, and rapid changes in level of consciousness
Call for assistance, notify physician, place them in Fowler’s position, keep warm and quiet, vitals, no food or drink, oxygen, don’t leave patient alone, possible IV fluids and medications (physician), and be ready for CPR
Cardiogenic shock
Compression of heart by an accumulation of fluid in the pericardial sac
Cardiac tamponade
Feet about 45-60° lower than head
Fowler’s position
Abnormal distribution of blood flow in the smallest blood vessels results in pooling of blood in vessels and inadequate supply of blood to body’s tissues and organs
Distributive shock
3 types of distributive shock
Neurogenic
Septic
Anaphylactic
Occurs when concussion, spinal cord injury, psychic trauma, or spinal anesthesia causes abnormal dilation of the peripheral blood vessels; causes fall in BP as blood pools in veins, mental disorder, aggravating emotional situation, etc.
Vasodilators stop contracting
Hypotension, warm dry skin, visible signs of poor tissue perfusion, cool extremities, and diminishing peripheral pulses
Notify physician, assistance, keep patient flat, monitor vitals every 5 minutes, don’t move if there’s a spinal injury, oxygen, IV fluids and medications, etc.
Neurogenic shock
Caused by severe systemic infections and bacteria; caused by gram negative bacteria (most common), gram positive bacteria, and viruses
Body’s immune system responds and releases chemicals
Place patient supine/flat, calm and quiet, don’t leave alone, cover patient if they feel warm, give oxygen, IV fluids and medications, etc.
Septic shock
2 phases of septic shock
Early/first phase
Late/second phase
6 symptoms of early/first phase septic shock
Warm and flushed skin Urine output normal to excessive Increased heart and respiratory rate Nausea and vomiting (N&V) Possible confusion
6 symptoms of late/second phase septic shock
Abrupt decrease in level of consciousness Decrease in urine output Cold and clammy skin Seizures Cardiorespiratory failure Rapide heart and respiratory rate
Similar to neurogenic shock; result of exaggerated hypersensitivity reaction to an antigen that was previously encountered by the body’s immune system, drug reaction
Varies with time of onset: mild within two hours, moderate more rapid, and severe = abrupt
Mild to severe: tightness in chest, itching at site of injection, nasal congestion, sneezing, choking, decreasing BP, dilated pupils, seizures, and respiratory and cardiac arrest
Keep emergency cart available, get history (allergies, GFR, creatinine, BUN, etc.), etc.
Anaphylactic shock
4 major types of diabetes mellitus
Type 1
Type 2
Diabetes mellitus associated with or produced by other medical conditions or syndromes
Gestational diabetes
Disease in which the body’s ability to produce or respond to insulin hormone impaired
Diabetes mellitus
Insulin-producing beta cells are destroyed by autoimmune process; pancreas produces little or no insulin
Usually under 30, abrupt onset
Must receive insulin injections
Not preventable or curative
Type 1 diabetes mellitus/insulin-dependent
Inherited metabolic disorder characterized by hyperglycemia with resistance to ketosis
Usually over 40, gradual onset
Results from an impaired sensitivity to insulin or from a decreased production of insulin
Controlled by diet, exercise, and weight loss
Can be cured/fixed
Type 2 diabetes mellitus
Occurs in later months of pregnancy and is caused by hormones secreted by the placenta that prevent the action of insulin, treatment with diet but may need insulin
Gestational diabetes
3 diabetic emergencies
Hypoglycemia
Ketoacidosis
Hyperosmolar nonketotic syndrome
Low blood sugar, high insulin; sugar less than 50-60 mg/deciliter (dL)
Occurs when persons who have diabetes mellitus have an excess amount of insulin in their bloodstream, an increased rate of glucose, or inadequate food intake with which to use the insulin
Mild tremors, sweating, dizziness, headache, disorientation, and impaired motor function (drastic)
Hypoglycemia
Normal sugar levels, what happens when it’s less than 40 mg/dL (3), and over 90 mg/dL (3)
Normal: 70-90 mg/dL
<40: kidney disease, hypopituitarism and -insulinism, etc.
>90: diabetes mellitus with high blood sugar and hyperthyroid- and -pituitarism
Occurs when there’s an insufficient insulin in the body, associated with hyperglycemia
Body breaks down/uses stored fats and muscle instead of glucose
Weakness, drowsiness, sweet odor to breath, warm dry skin, flushed face, tachycardia, and coma
Check chart for diagnosis of diabetes, notify physician, call for assistance, monitor vitals, don’t leave patient, administer oxygen and IV, etc.
Ketoacidosis
High sugar, low insulin
Hyperglycemia
Occurs due to the loss of effective insulin, leading to diuresis and loss of fluid and electrolytes
Insulin not working; secondary to acute illness, ex: NPO for a long time period
Often appear to be drunk or have had a stroke, dehydration, dry skin, hypotension, tachycardia, mental confusion, seizures, and stroke
Call for assistance
Hyperosmolar nonketotic syndrome
Caused by an occlusion of one or more pulmonary arteries by a thrombus or thrombi that originates in the venous circulation
Usually associated with trauma, surgery, pregnancy, and immobility
Sudden onset of symptoms: CP, dyspnea, tachypnea, tachycardia, syncope, coma
Moves = death
Blood thinners, call for help, notify physician, monitor vitals, and don’t leave them alone
Pulmonary embolus
Inadequate gas exchange by respiratory system; many causes by obstruction such as tongue, vomit, injury, etc.
Respiratory failure
Heart stops beating
Cardiac arrest
3 steps of CPR (get help)
Circulation
Airway: make sure it’s clear
Breathing
Tilt chin up to open airway and watch for bilateral rise and fall of chest; mouth to mouth, mask, or bag
Breathing
Compressions on hard, flat surface; 1.5-2 inches deep
Circulation
CPR: ___ compressions and ___ breaths
30, 2
Caused by occlusion or rupture of the cerebral blood supply directly into the brain tissue or into the subarachnoid space
Severe headache, eye deviation, difficult speech, ataxia, loss of consciousness, N&V, stiff neck, and paralysis on one side of body
Call for aid, put patient in resting position with head slightly elevated, monitor vitals, ready to give IV, oxygen and CPR if patient stops breathing, etc.
Cerebrovascular attack/stroke
Loss of coordination
Ataxia
Caused by insufficient supply of blood to the brain; heart disease, hunger, poor ventilation, fatigue, emotional shock are all causes
Cold clammy skin, tachycardia, dizzy, nausea, pallor, hyperpnea
Trendelenburg
Fainting/syncope
Increased depth and rate of breathing
Hyperpnea
Loss of pigmentation/color
Pallor
Head lower than feet
Trendelenburg
Unsystematic discharge of neurons of the cerebrum that results in an abrupt alteration in brain function in brain function
Can be caused by infectious disease, high fever, extreme stress, head trauma, and brain tumors
No driving
Convulsive seizures
Whole body convulses and the patient loses consciousness for a period of minutes
Muscles become rigid, eyes open, jerky body movement, vomiting, frothy saliva, urinary or fecal incontinence, usually fall asleep following seizure because muscles are tense the entire time
Grand mal
May be restricted to a specific part of the brain, patient is not responsive to the environment although appears to be awake
Lasts 1-4 minutes
Lip smacking, chewing and facial grimacing, patting, picking, and rubbing one’s clothing, and confusion for several minutes following seizure
Partial seizure
2 types of convulsive seizures
Grand mal/generalize seizure
Partial seizure
Partial seizure that is so brief that an observer may not be aware that it has occurred, harder to control medically; rare in adults
A brief loss of awareness, blank stare, eye blinking, mild body movements, and sudden loss of all muscle tone resulting in afall
Petit mal/absence seizure
Have hollow lumen so secretions and air may be evacuated/suctioned or medications, nourishment, or contrast agents may be administered
Made of polyurethane silicone rubber
Placed in nose or mouth
Must be in place before any medication, for, water or contrast is given
Nasogastric (NG) and nasoenteric (NE) tubes
Short-term tube that can be placed by nurse
Nasogastric (NG) tube
Allows peristalsis to pass through into duodenum and small intestine
Long-term, weeks to months
Placed by physician
Nasoenteric (NE) tube
3 ways to tell if Nasogastric (NG) and nasoenteric (NE) tubes are properly placed
Radiographic film
Fluoroscopy
Aspirate gastric contents and test on litmus paper, gastric contents are acidic; pH less than 7
Max suction on adults, older kids, and infants
Adults: 110-150 mmHg
Kids: 100-120 mmHg
Infants: 50-95 mmHg
Temporary or permanent tube that is directly into the stomach through an incision
Usually when esophagus is blocked or cannot go through nose or mouth
Patient sedated and endoscope used to verify placement
Gastrostomy tube
An opening into the trachea created surgically either to relieve respiratory distress caused by obstruction of the upper airway or to improve respiratory function by permitting better access of air to the lower respiratory tract
Usually plastic or metal
Disease in head and neck
Difficulty speaking or fear of choking; keep in Fowler’s position
Tracheostomy
2 signs for emergency suctioning
Audible rattling or gurgling sounds coming from the patient’s throat
Gagging or breathing with difficulty
Usually used for hemothorax, pneumothorax, or pleural effusion
Tube inserted into the pleural cavity and attached to water-sealed drainage to remove air and fluid from intrapleural space
Chest tube
Blood in pleural cavity doesn’t allow lung to expand
Hemothorax
Air/gas in cavity between lung and chest wall, causing lung to collapse
Pneumothorax
Excess fluid/water that accumulates in pleural cavity
Pleural effusion
Component of chest tube that keeps atmospheric air from getting back into lung
Water seal
Clamp ______________ tube when transporting patient, never clamp ________________
Nasogastric (NG) and nasoenteric (NE) tubes
Chest tube
Drains placed at or near wound sites or operative sites when large amounts of drainage are expected, done due to fluid interfering with healing process because the fluid is absorbed slowly by body
Place with aseptic technique to prevent infection
Ex: hip and spine surgery
Tissue drains
4 examples of tissue drains
T-tube for gallbladder surgery attached to common bile duct
Penrose
Jackson-Pratt
Hemovac
Drain placed in wound after mastectomy, neck surgery, etc. and allows gravity to pull fluid
Penrose drain
3 diseases requiring airborne precautions
Measles
Varicella (including disseminated zoster)
TB
6 diseases requiring droplet precautions
Diphtheria Pertussis Pneumonic plague Mumps Rubella Influenza
