Acute Care Equipment

Question 1

What is this?

Answer 1

Arterio-venous (AV) Fistula

Question 2

Arterio-venous (AV) Fistula - Purpose and Clinical Consideration

Answer 2

Purpose/Decription
- Provides access for hemodialysis
- Fistula is the surgical joining of an artery and vein, allowing arterial blood to flow directly to a vein.
- Usually located in the forearm.

Clinical Consideration
- Do not use BP cuff on involved extremity
- Avoid pressure over site
- Palpable turbulence (rush of fluid) is normal

Question 3

What is this?

Tube going into veins near the heart

Answer 3

Central (Venous) Line

Question 4

Central (Venous) Line

Answer 4

Purpose
- Provides vascular access for repeated blood sampling or administration of drugs or fluid

Clinical Consideration
- Do not use a blood pressure cuff on same extremity as central line
- Central venous pressure (CVP) normal value = 0-8 mmHg
- Don’t need to memorize value

Question 5

What is this?

Answer 5

Chest Tube

Question 6

Chest Tube

Answer 6

Purpose: Remove and prevent re-entry of fluid from pleural space

Clinical Manifestations:
- May cause discomfort
- Drainage system should be BELOW level of tube insertion
- Avoid tipping collection reservoir
- If dislodged, stop activity and notify nursing
- Should not limit patient’s activity

Question 7

What is this?

Answer 7

Endotracheal Tube

Question 8

Endotracheal Tube

Answer 8

Purpose:
- Required to maintain open airway or provide ventilatory support (Through nose, into trachea forming an airway)
- Secured by balloon cuff near end of tube.
- Cuff ensures O2 being delivered enters lungs and help hold artificial airway in place.

Clinical Consideration:
- Cuff leak should be considered if patient is able to make audible sounds.
- Notify nurse or respiratory therapist if cuff leak is suspected.
- Can be used to suction patient of excess oral secretions.

Question 9

What is this?

Answer 9

Tracheostomy Tube

Opening directly into the trachea. Someone might have this is for long term.

Question 10

Tracheostomy Tube

Answer 10

Purpose:
- Identical in purpose to endotracheal tube but may be used for longer time is airway support is required.
- Inserted into anterior trachea below vocal cords.
- Reduces laryngeal injury, improves oral comfort
May be used for suctioning.

Clinical Manifestations:
- Cuff leak should be considered if patient is able to make audible sounds.
- Notify nurse or respiratory therapist if cuff leak is suspected.
- Can be used to suction patient of excess oral secretions.

Question 11

What is this?

Answer 11

Nasogastric Tube

Question 12

Nasogastric Tube (NGT)

Answer 12

Purpose:
- Keeps the stomach empty after surgery and rests the bowel
- Tube inserted through nostril, esophagus, and into stomach
- Held in place with tape across the nose

Clinical Considerations:
- Ask nursing if the tube may be disconnected from suction to mobilize patient

Question 13

What is this?

Answer 13

Percutaneous Endoscopic Gastronomy/Jejunostomy Tube (PEG/PEJ)

Question 14

PEG/PEJ

Answer 14

Purpose:
- Provides long-term access for nourishment to patients unable to tolerate food via mouth
- Feeding tube in stomach or jejunum through abdominal wall

Clinical Cosiderations:
- Place tube feedings on hold when head of bed is flat to minimize risk of regurgitation or aspiration

Question 15

What is this?

Answer 15

Peripherally Inserted Central Venous Catheter (PICC)

Question 16

PICC

Answer 16

Purpose:
- Long term administration of Total Parenteral Nutrition (TPN), medications, or fluids
- Catheter placed via cephalic or basilic veins terminating in superior vena cava

Clincial Manifestations:
- Do not use BP cuff of involved extremity
- Encourage ROM of involved extremity
- Axillary crutches may be contraindicated

Question 17

What is this?

Answer 17

Colostomy/Ileostomy Pouch

Question 18

What is this?

Answer 18

Rectal Pouch/Tube

Question 19

Rectal Pouch/Tube

Answer 19

Purpose:
- Temporary collection of bowel drainage
- Protects fragile skin from contact with feces
- Pouch placed externally or tube place internally in rectum

Clinical Considerations
- Easily dislodged
- Use draw sheet when moving patient in bed
- Keep collection bag below level of insertion

Question 20

What is this?

Answer 20

Suprapubic Catheter

Question 21

Suprapubic Catheter

Answer 21

Purpose:
- Drains bladder temporarily after some bladder surgeries or severe voiding dysfunction
- Catheter placed in bladder through surgical insertion in lower abdominal wall

Clinical Manifestations:
- Keep collection bag below level of the bladder

Question 22

What is this called?

Answer 22

Surgical Drain

Question 23

Surgical Drain

Answer 23

Purpose:
- Removes blood or fluid from a surgical site that would otherwise collect internally

Clinical Considerations:
- Be aware of drain location when moving patient
- Tubing may be taped or pinned to patient’s skin or clothes to prevent tugging

Question 24

What is this?

Answer 24

Urinary (Foley) Catheter

Question 25

Foley Catheter

Answer 25

Purpose:
- Temporarily drains and collects urine from bladder
- Tube inserted through urethra into the bladder that drains into a collection bag
- Held in place internally by an inflated cuff

Clinical Considerations
- Be aware of the position of the catheter
- Keep below the bladder to allow drainage by gravity
- More practice time in spring Acute Care

Question 26

What is this?

Answer 26

Ventriculoperitoneal Shunt (VP)

Question 27

Ventriculoperitoneal Shunt

Answer 27

Purpose:
- Drain excess CSF from the brain into abdominal cavity or heart
- Shunt tunneled under skin from cerebral ventricles into collection cavity

Clinical Considerations
- Shunt can often be palpated under the skin
- Avoid excess pressure over the shunt