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CI1 > Surgical Attachments & Drains > Flashcards

Surgical Attachments & Drains Flashcards

1
Q

What do the following words mean?

  • Ectomy
  • Otomy
  • Oscopy
  • Ostomy
A

Ectomy: Removal of
Otomy: Cutting into
Oscopy: Looking into
Ostomy: Opening into

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2
Q

What is a laparotomy incision used for?

A
  • Removal of cancerous bowel, spleen, pancreas, gall bladder, stomach or liver
  • Division of adhesions (scar tissue) interfering with bowel movement
  • Repair of abdominal aortic aneurysm (AAA)
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3
Q

What is a sternotomy incision used for?

A

Cardiac surgery

  • Cardiac artery bypass grafting (CABG)
  • Aortic or mitral valve replacement
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4
Q

What is a thoracotomy incision used for?

A

Thoracic surgery

- Removal of lung cancer (pneumonectomy, lobectomy)

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5
Q

What are considered to be attachments?

A

Anything that is not part of a patient’s body but is connected to them in some way

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6
Q

What is an arterial line?

A
  • Plastic catheter that goes into an artery
  • Connected to transducer
  • Most commonly in radial artery
  • Only in ICU
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7
Q

What are the 2 main functions of an arterial line?

A
  • Allows frequent/painless ABG sampling without a Dr present

- Constantly monitors BP

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8
Q

What would happen if an arterial line was dislodged?

A

Heavy arterial bleeding

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9
Q

Why is a resting splint sometimes used with an arterial line?

A
  • To prevent it from being dislodged

- To keep the wrist neutral & prevent kinking in the artery

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10
Q

What is a central venous catheter (CVC) or central line?

A
  • Tube into superior vena cava in right atrium
  • Connected to transducer
  • Can be jugular or subclavian
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11
Q

What are the 2 main functions of a central line?

A
  • Fast administration of drugs/fluids

- Measurement of central venous pressure (CVP) - gives an indication of heart performance

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12
Q

What is a variation of a central line?

A

Peripherally inserted central catheter (PICC line) - Long term central line

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13
Q

What is an epidural?

A
  • Injection into epidural space outside dura mater
  • Combination of anaesthetic & opioid
  • Can be at any spinal level
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14
Q

What is an epidural often used in?

A
  • Childbirth
  • AAA repair
  • Hip replacement
  • Intestinal surgery
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15
Q

What are some important things to note about epidurals?

A
  • Very fine tubing, easy to dislodge (yellow stripe)
  • Sensory vs motor block (motor block is bad, monitored with BP)
  • Often require oxygen therapy
  • Patient can be mobilised (check for motor block first)
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16
Q

What should be monitored on patients who have had an epidural?

A

Blood pressure

17
Q

What is an intravenous catheter (ICV)?

A
  • Simple catheter inserted into peripheral vein

- Allows delivery of fluids and medications (i.e. drip)

18
Q

What is an indwelling catheter (IDC)?

A
  • Catheter inserted into bladder, held via balloon
  • Used to drain urine
  • Attached to drainage bag
19
Q

What is important to remember when handling patients with an IDC?

A
  • Keep the bag below the bladder

- Keep the bag close to the patient (can hang off frame)

20
Q

What is an intercostal catheter (ICC)?

A
  • Tube inserted into pleural space
  • Sutured in place
  • Attached to underwater sealed drain (UWSD)
21
Q

What is the function of an ICC?

A

Used to drain air (pnemothorax), blood or pleural effusion

22
Q

What is the function of under water sealed drains (UWSDs)?

A
  • Allows tube drainage but not air to rise back into pleural space
  • Measures drainage in mL
  • Attached to wall suction - constant pressure to prevent pneumothorax
  • Can see ‘swing’ and ‘bubble’ (indicator of ongoing air leakage)
23
Q

What are some of the safety issues associated with UWSDs?

Exam question

A
  • Always have clamps nearby (clamp tube close to chest if UWSD fails/breaks to prevent air going in)
  • Always keep UWSD below patient’s chest (avoid drainage running back into pleural space)
  • Always check if patient requires continuous suction or is allowed to mobilise without suction
24
Q

What is a naso gastric tube (NG)?

A
  • Inserted through nose into stomach
  • Inserted blind by medical staff
  • Requires CXR to double check placement
  • Secured with tape
25
Q

What is the function of a NG?

A

Allows feeding directly into stomach or drainage of stomach

26
Q

Why would you remove a NG when mobilising/exercising?

A

So digestion can be paused

27
Q

What is an exception to removing a NG during mobilisation?

A

High insulin dependency requiring constant feed to maintain blood sugar level

28
Q

What are pacing wires?

A
  • Wires placed directly after cardiac surgery (ensures cardiac output)
  • Attached to pacing box (set heart rate)
29
Q

Where can a pacing box be placed when moving a patient?

A

Tucked into the patient’s cough teddy

30
Q

When are pacing wires typically removed?

A
  • 2-3 days post survey if spontaneous heart rhythm established
  • Patient required to rest in bed for 1-2 hours post removal (check with nurses before mobilising cardiac surgery patients)
31
Q

What is a cardiac portable telemetry?

A
  • Mobile continuous ECG recording
  • Externally attached ECG dots
  • ECG relayed to monitor at nursing station and/or bedside monitor
32
Q

What are ostomys and somas?

A
  • Surgically created openings from internal organs to skin
  • Allows excretion of faecal matter bypassing lower GI tract
  • Attached to drainage bags
33
Q

What are wound drains?

A
  • Passive bags that drain fluid/blood without suction
34
Q

What is important to remember about wound drains?

A
  • Identify every drain
  • Keep below incision site if possible
  • Can be hung off walking frames if safe
  • Patients may be able to carry small bags
35
Q

What are TED stockings?

A
  • Anti-embolism compression devices
  • Routinely used post surgery
  • Hole at toe end
36
Q

What should you do to avoid a patient slipping in TED stockings?

A
  • Slippers

- Roll up so at least ball of foot is exposed

37
Q

What is the function of mechanical/sequential calf compressors?

A
  • Inflation/deflation of balloons around calves
  • Anti-embolism
  • Attached with velcro, easily removed

CI1 (21 decks)

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