Lines, Drains and Fluids

Question 1

What are the Types of acess?

Answer 1

Peripheral Access

Central access

Question 2

What are the types of Peripheral Access?

Answer 2

IV
PICC
Intra arterial line

Question 3

What are the types of Central Access?

Answer 3

Central Venous Cath
Cordis- PA catheter
Hemodialysis cath
Hickman Cath
Venous access port
Arterial Stick

Question 4

What is IV access used for?

Answer 4

Routine medication admin

Routine Fluid resusc

Question 5

WHat are the complications of IV access?

Answer 5

Pain
Infection
Hematoma
Infiltration

Question 6

What are the Uses of PICC lines?

Answer 6

Long term meds
Poor IV acess
Not indicated for rapid fluids

Question 7

What are rhe complications of PICC lines?

Answer 7

Venous thrombosis
Malposition/dislocation
Infection

Question 8

WHat is the Location of PICC lines?

Answer 8

Antecubital

Question 9

WHat is the Location of CVC lines?

Answer 9

Internal Jugular
Subclavian
Femoral

Question 10

What are rhe complications of CVC lines?

Answer 10

Pneumothorax
Infection
Arterial puncture

Question 11

What are the Uses of CVC lines?

Answer 11

Fluid Resusc (rapid)
Multiple med lines
Invasive monitoring (central venous pressure)

Question 12

What are the uses of Cordis Lines?

Answer 12

Fluid Resusc
PA cath
Invsive monitoring 
Surg with possible blood loss
Multiple med lines if CVC fed through

Question 13

What are rhe complications of Cordis lines?

Answer 13

Pneumothorax

Massive Hemorrhage

Question 14

What are rhe complications of PA catheters?

Answer 14

PA rupture
Papillary muscle damage
Valvular damage

Question 15

What are the uses of PA Catheters?

Answer 15

Critically ill with cardiac instability
Major CV surgery
Hemodynamic Monitoring
-Cardiac Output
-Systemic Vasc Res
-Pulm Cap Wedge Pressure (volume status)

Question 16

What is the location of a Hemodialysis Catheter?

Answer 16

IJ
Subclavian
Femoral

Question 17

What is the USE of a Hemodialysis Catheter?

Answer 17

Acute Hemodialysis

Chronic Hemodialysis

Question 18

What is the Complications of a Hemodialysis Catheter?

Answer 18

Clotting

Bleeding

Question 19

What is the location of a Hickman Catheter?

Answer 19

Subclavian

IJ

Question 20

What is the USE of a Hickman Catheter?

Answer 20

Long term med Administration

Question 21

What are the Complications of a Hickman Catheter?

Answer 21

Pneumothorax
Bleeding
Infection

Question 22

What are the Complications of a Venous Access Port Catheter?

Answer 22

Dislocation

Breakage

Question 23

What are the Uses of a VAP Catheter?

Answer 23

A port with a line
Prolonged IV access
Long medication admin (chemo)

Question 24

What are the locations of a VAP Catheter?

Answer 24

Subclavian

IJ

Question 25

What are the different types of Drains?

Answer 25

``` Penrose Hemovac Chest Tube/Pleurovac T-Tube Enteral Feeding Tubes -NG/OG -Gastrotomy tube -Jejunostomy Tube ```

Question 26

What is the penrose tube?

Answer 26

A flat rubber tube that is easliy cut/perforated | Free drainage of dependent fluid in neck or extremity

Question 27

What is the JP/Blake tube?

Answer 27

``` Semi rigid plastic attached to a suction device Various sizes and shapes Post-op drainage PC drainage (turn off suction first!) ```

Question 28

What is the Hemovac?

Answer 28

Self contained unit External chamber for suction Post-op drainage

Question 29

What is the Chest Tube/Pleurovac?

Answer 29

Chest tube draining device - suction vs water seal - collection chamber - tidaling and air leak

Question 30

What is the use of the Chest Tube/Pleurovac?

Answer 30

Trauma Pneumothorax Hemothorax Post-op

Question 31

What are the different types of T-Tubes?

Answer 31

Cholecystectomy tubes Percutaneous Transhepatic Cholangiocatheter (PCT) T-Tube

Question 32

What are the uses of T-Tubes?

Answer 32

Drain biliary tract Post op CBD exploration Drain obstructed biliary tract Acute cholecystitis

Question 33

WHat are the uses of a G-tube?

Answer 33

Enteral feeding Drainage of the stomach Fixation of stomach to abd wall

Question 34

WHat are the Complications of a G-tube?

Answer 34

Infection/Abcess formation Fall out/pulled out Leakage

Question 35

What is a J tube? used for?

Answer 35

Red rubber catheter from abdominal wall to jejunum Surgical placement Use: Feeding for patietns w/ upper GI malignancy whenG tube is CI.

Question 36

What is an NG/OG tube? Use? | Complications?

Answer 36

Small lumen tube from Nose/mouth into stomach Use: Enteral Feeding, Medications Aspiration

Question 37

WHat are the Standard Rates of IV fluid?

Answer 37

Adult: UOP 1/2 ml/kg/hr Child: UOP 1 ml/kg/hr Infant (up to 1 yr): UOP 2 ml/kg/hr

Question 38

How is Maintenence fluid calculated?

Answer 38

(100/50/20) 100 ml/kg for 1st 10 kg 50 ml/kg for next 10 kg 20 ml/kg for additional kg

Question 39

How is Maintenence fluid per hour calculated?

Answer 39

(4/2/1) 4 ml/kg for 1st 10 kg 2 ml/kg for next 10 kg 1 ml/kg for additional kg

Question 40

What is the maximum amount of K+ replacement can be given through a peripheral IV? Central Line?

Answer 40

10 mEq/hr | 20 mEq/hr