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Flashcards in Chapter 14 Deck (61):
1

What is NG Tube?

Nasogastric Tube
plastic or rubber tubes
Inserted through the nasopharynx into the stomach

2

NG Tube is used for

Administration of medications
Gastric decompression (most common)
Removal of gas (flatus) & fluids from stomach after intestinal obstruction or major trauma

3

5 types of NG tube are

Levin (common)
Sump (common)
Nutriflex
Moss
Sengstaken-Blackemore (S-B)

4

Levin tube

Most common
1 lumen
Plastic
Passed through nose into stmach

5

Levin tube used for

Gastric decompression

6

Sump tube also called

Salem-sump tube
Most common

7

Sump tube is

Double-lumen
Blue extension (* pig-tail) is the 2nd lumen
Lets air flow into stomach

8

Nutriflex tube

1 lumen
mercury-weight tip
feeding

9

Moss tube

3 lumen-complex
Balloon to anchor into stomach
2nd & 3rd lumen used for aspiration & feeding

10

Sengstaken-Blackemore tube
(S-B)

3 lumens
thick catheter
2 balloon
control bleeding from esophagus

11

Nasogastric Tube Equipment

NG tube
Water-soluble lubricant
20 to 50 ml syringe
Tetracaine
Contrast (under fluoro in correct place)
Tissue
Tape
Emesis basin
Gloves
Towels
Glass of water with straw
Saline (flush it)

12

Nasoenteric Tube (NE Tube)

Same material as NG tubes
Inserted same as an NG
Passes into duodenum & small intestines by peristalsis
Weighted metal tip (single)

13

NE Tube used for

Decompression
Diagnosis
Treatment

14

3 types of NE tube

Cantor
Harris
Miller-Abbott

15

Entriflex / Dobhoff tube

Single narrow lumen tube with removable wire stylet
Placed into duodenum or jejunum
Not used with suction
Thinner & more flexible than NG tubes
Leave in for long periods of time

16

Gastrostomy Tube

A surgical creation of an opening into the stomach from where a tube is placed from inside the stomach to the external abdominal wall

17

Gastrostomy Tube Used for

Feeds a patient who cannot tolerate the intake of oral food
Temporary or permanent

18

Most common type of Gastrostomy Tube is

PEG tube (percutaneous endoscopic gastrostomy)
Placed during endoscopy or surgery

19

Central Venous Lines also called

central venous catheters or venous access devices
Also named for developer – Hickman or Groshong

20

Central Venous Lines

Wide variety of clinical application
Administer a variety of drugs
Manage fluid volume
Serve as a conduit for blood analysis & transfusions
Monitor cardiac pressure

21

Central Venous Lines mainly used for

chemotheraphy & parenteral nutrition
May be single-, double-, or multi-lumen

22

Most common insertion site of Central Venous Lines is

Subclavian vein
Can also use internal jugular & femoral veins

23

Position of Central Venous Lines should be

Superior vena cava – approximately 2 to 3 cm above opening of right atrium

24

Pulmonary Arterial (PA) Catheter also called

Swan-Ganz catheters

25

Pulmonary Arterial (PA) Catheter

Single- or multi- lumen CV lines
Incorporates a small electrode @ distal end, used to monitor arterial pressure
Distal tip will be in one of the two pulmonary arteries
Enters through the right internal jugular & ends in right PA

26

Peripherally inserted central catheter (PICC)

Inserted by a nurse/radiologist/or specially trained radiographer
Inserted into the patient’s arm and advanced until its tip lies in a central vein (best side of pt)

27

Implanted Access Port

Port-A-Cath, Infusa Port, Mediport (lung)(pt w/port not have a good vein)

28

Implanted Access Port used for

Patients with long term illnesses requiring frequent IV medications or transfusions

29

Implanted Access Port made of

plastic, titanium or stainless steel

30

Implanted Access Port Implanted into

the subcutaneous tissue of the chest
Not visible but can be palpated
Catheter from the port is inserted into the subclavian or internal jugular vein
Utilizes a huber needle

31

Emergency Suctioning indication

Profuse vomiting in a patient who can not voluntarily change their position
Audible rattling or gurgling sounds coming from patient’s throat
Signs of respiratory distress

32

Emergency Suctioning purpose

To prevent aspiration or respiratory arrest
(It is not within our practice to perform suctioning.)

33

Contraindications for Suctioning

Head or facial injuries
Bleeding esophageal varices
Nasal deformities
Trauma
Cerebral aneurysms
Tight wheezing, bronchospasm or croup

34

Suctioning Equipment

Wall outlet or working portable suction machine
Sterile gloves
Tubing
Disposable suction set with various catheter sizes
10 F to 18 F Adults
5 F to 8 F Children
Sterile container for solution
Sterile water or sterile normal saline
Oxygen
Gown, mask and goggles

35

Tracheostomy

An opening into the trachea that is created surgically to provide a temporary/permanent artificial airway to a patient
Provides an airway during upper airway obstruction

36

Tracheostomy Tube Indications

Traumatic injury
Paralyzed
Unconscious or suffering from disease which has affected respiration

37

Tracheostomy Tube Precautions

Metal or plastic design
Cuff
Helps to seal the tracheostomy to prevent air leaks or aspiration
Ties to hold in place
Do not untie and do not remove the tube
Patients are suctioned
Explain procedure to patient

38

Mechanical Ventilator

Artificial airway connected to a mechanical ventilator
Patients are not able to breath spontaneously
Endotracheal tube or tracheostomy tube

39

Ventilator delivers

a minimum set respiratory rate, preset inspiratory volume, and consistent FiO2
Radiographs may be taken to confirm correct placement

40

Manual ventilation

Use an Ambu bag (blue color)
A device that is squeezed regularly by hand to force respirations
Used during transportation and when setting up ventilation

41

Clinical term used is for Ambu bag is

“bagging patient”

42

Endotracheal Tubes

Tube inserted through the mouth into the trachea with correct placement of tip 5 to 7 cm above the tracheal bifurcation

43

Endotracheal Tubes Indications for use

Need mechanical ventilation or oxygen delivery due to inadequate breathing
Inadequate arterial oxygenation
Parenchymal diseases that impair gas exchange
Upper-airway obstruction
Impending gastric acid reflux or aspiration

44

Endotracheal Tubes: Radiographs needed for placement and thereafter

20% require repositioning of tube
Malpositioning into right main-stem bronchus which causes overventilation of right lung & possible airway obstruction to left (atelectasis)

45

Thoracostomy Tubes also called

CHEST TUBE

46

Thoracostomy Tubes USES FOR

Drain intrapleural space & mediastinum
Fluid or air accumulate
Creates a negative pressure
Fluid or air accumulate causing pressure to be lost and the lungs fail to expand fully
If too low a pressure, lungs collapse

47

Thoracostomy Tubes Condition

Pneumothorax (air)
Hemothorax (blood)
Pleural effusion (fluid)
Empyema (infective)

48

Thoracostomy Tubes insertion site vary

with the intrapleural substances to be removed (pt can have more than 1 chest tube)

49

Fluids (hemothorax or pleural effusion):

usually inserted in 5th to 6th intercostal space
Can be as high as 4th intercostal space and as low as 8th

50

Air (pneumothorax):

requires a higher insertion because air rises
2nd to 3rd intercostal space @ midclavicular line

51

Tissue Drains

Placed at or near a wound site or operative site
One end of the tube or drain is placed in or near the operative site, and the other end exits the body wall

52

3 common postoperative drains

Hemovac
Jackson-Pratt
Penrose

53

Penrose drain

Soft rubber tube
Sterile safety pin keeps tube from slipping into surgical wound
Drains into a surgical dressing

54

Jackson-Pratt and Hemovac drains

Plastic drainage tube
Maintains a constant low negative pressure
Drainage goes from tubing into bulb
Used for hip surgeries

55

Urinary Catheters

Indwelling catheter (catheter that remains inplace)
Insertion of a tube into the bladder using aseptic technique

56

Two main types of Urinary Catheters

Retention balloon (Foley) (B)
Straight type (A)

57

How to Use French system for sizing

8 F to 18F (outer diameter of catheter)
Choose larger size when possible

58

Balloon is filled with

Balloon is filled with sterile water to hold catheter in place after insertion

59

Drainage bag must be

kept lower than patient’s bladder @ all times to prevent retrograde flow into bladder
Failure to do so can lead to infection
Bags should never drag on floor

60

When transferring patients by wheelchair or stretcher

Ensure that the drainage bag & tubing do not become entangled in wheels or caught on passing objects.

61

Urinary Catheter purposes

Bladder emptying
Relieve bladder retention
Irrigate bladder
Introduce drugs into bladder
Permit accurate measurement of urine output
Relieve incontinence