Alternative Procedure and Medical Devices Review Flashcards Preview

Hannah RAD III > Alternative Procedure and Medical Devices Review > Flashcards

Flashcards in Alternative Procedure and Medical Devices Review Deck (31):
1

What are the terms used for the radiographic study of the biliary system, gallbladder and biliary ducts?

-Cholegraphy – biliary system
-Cholecystography – gallbladder
-Cholangiography – biliary ducts

2

***What does PTC stand for?

Percutaneous Transhepatic Cholangiography

3

***What does ERCP stand for?

Endoscopic Retrograde Cholangiopancreatography

4

PTC Procedure:

-Right side of patient is prepped with local anesthetic

-Chiba needle is inserted through right lateral intercostal space and advanced to liver hilum

-Stylet is removed and syringe with contrast is attached to needle

-After filling of ducts needle is withdrawn

5

PTC Procedure:

-If dilated biliary ducts are identified, a drainage catheter is placed into biliary duct

-Guidewire is passed through needle lumen & needle is removed

-Catheter is passed over guidewire and wire is removed

-Left in place for prolonged drainage

6

***Explain the postoperative t-tube cholangiograpm:

-Exams the biliary tract using a T-shaped or pigtail shaped catheter

-Follows a cholecystectomy
Left in common hepatic & common bile ducts for postoperative drainage

7

***What type of procedure is used to place a T-tube and pigtail catheter?

-T-tube is placed during a surgical procedure

-Pigtail catheter is placed during a laparoscopic biliary procedure

8

***What is the purpose of the postoperative T-tube cholangiogram?

-Demonstrates caliber & patency

-Status of sphincter of hepatopancreatic ampulla

-Presence of stones or other pathologic conditions such as strictures

9

Why is the drainage tube clamped the day before the procedure?

Allows tube to fill with bile to prevent air bubbles within the duct from mimicking stones (preventive measure)

10

***What is the purpose for an ERCP?

-It is used to diagnose biliary and pancreatic pathology

-It is useful when biliary ducts are not dilated and no obstruction exist @ ampulla

-Therapeutic procedure
-Removal of choleliths or small lesions
-Repair a stenosis of a duct

11

***ERCP Procedure:

-Endoscope is placed through mouth into duodenum

-A small cannula is passed into the hepatopancreatic ampulla

-Contrast is then injected into common bile duct (retrograde injection)

-Contrast drains from ducts within 5 minutes of injection

12

What is another name for a chest tube?

Thoracostomy or intrapleural tube

13

Where is a chest tube inserted?

-Fluid accumulates near lung base
-5th to 6th intercostal space @ midaxillary

-Air rises to upper pleural space
-2nd to 3rd intercostal @ midclavicle

14

***A chest tube is inserted to reestablish intrapleural pressure that may be caused by what various conditions?

-Pneumothorax
-Hemothorax
-Pleural effusion
-Empyema

15

What is the purpose of an endotracheal tube (ETT)?

-Patient has need for mechanical ventilation or oxygen delivery
-Patient has upper airway obstruction
-Possibility of gastric acid reflux or aspiration

16

***Where is the proper placement of the endotracheal tube?

5 to 7 cm superior to tracheal bifurcation (halfway between clavicles and carina {T5-T7}

17

***Malpositioning of the endotracheal tube:

-If tube is inserted too far – enters the right bronchus causing a collapse of left lung or atelectasis

-If tube is too high – air enters the stomach and regurgitation leads to aspiration pneumonia

18

***What is the name of the catheter that is inserted into a large vein and has a variety of uses?

-Central venous catheter
-Venous access device
-Hickman/Groshong (developer)

19

What are some of the uses for the catheter mentioned in the previous question?

-Administer chemotherapeutic and other drugs
-Parenteral nutrition
-Manage fluid volume
-Blood analysis and transfusion
-Monitor cardiac pressure

20

***Where is the preferred location for a central venous line?

SVC approximately 2 to 3 cm above the right atrial junction

21

***What are some of the common insertion sites for central venous lines?

-Subclavian vein
-Internal jugular vein
-Femoral vein
-Antecubital area (PICC lines)
-Basilic vein
-Cephalic vein

22

***What type of line is a Swan-Ganz catheter?

Pulmonary arterial or PA line

23

What is a pulmonary arterial line?

-Single or multilumen CV line that contains a small electrode at distal end which is used to monitor pulmonary arterial pressure

-It enters through right internal jugular and ends in the right pulmonary artery

24

***Who performs the insertion of a PICC line?

Radiologist
Nurse
Specially trained technologist

25

***What are some of the uses of a PICC line?

-Prolonged antibiotic treatment
-Home health care for extended treatment
-Chemotherapy
-Nutrition

26

What is an implanted access device?

-A device surgically implanted under patient’s skin in the chest wall or patient’s arm.
-Tip lies in SVC
-Used for drawing blood or administering medications/contrast

27

***What type of needle is used to access an implanted access device (port)?

Huber needle

28

What are the primary uses for a nasogastric tube?

-Administration of medications
-Gastric decompression
-Removal of fluids from stomach after obstruction or trauma

29

What is the most common NG tube?

Levin tube
-Single lumen with several holes near its tip

30

What are some uses for the nasoenteric feeding tube?

-Feeding and hydration of patient
-Contrast administration
-Nasoenteric feeding tubes are thinner and more flexible than NG tubes.
-NE tubes can stay in for a longer period of time
-NE tubes are positioned @ the level of 3rd portion of duodenum

31

What is a PEG tube?

-Gastric feeding tube
-Percutaneous Endoscopic Gastrostomy
– most common type
-Inserted through a small incision into stomach/jejunum using surgery or endoscopy
-Used for long term nutrition