Lines, Drains, & Tubes Flashcards
(24 cards)
Placement: Brachial Artery, Radial Artery, or Femoral Artery. Placed by MD
Indications: Used to monitor arterial blood pressure, access for arterial blood gas (ABG), and collecting blood for lab data (CBC, Chemistry, Etc)
Arterial Lines
Placement: Any accessible vein (arm, leg, or foot). Usually placed by nurse for a duration of 3 days
Indications: Administration of drugs or fluids, blood transfusions, obtaining venous blood. CANNOT BE USED TO DRAW BLOOD
Intravenous Line
Catheter that is threaded through the internal jugular vein, antecubital vein, basilic or subclavian vein with tip usually resting in superior vena cava or right atrium.
Central Lines
Lines entering into the circulation through any peripheral vessel.
Peripheral Lines
Placement: Subclavian, Internal Jugular, Basilic, or femoral vein into superior vena cava. Placed by an MD for a duration of 2 to 3 weeks.
Indication: Monitoring central venous pressures, administering drugs, fluids, and transfusions, or Total Parenteral Nutrition (TPN)
Central Venous Catheter
Placement: Subclavian or internal jugular vein to pulmonary artery. Placed by MD
Indication: Monitoring heart pressures, cardiac output, core temperature, or pulmonary activity
Swan-Ganz Catheter (PA line or Pulmonary Artery Line)
Placement: Basilic (most common), cephalic or median cubical vein to superior vena cava or inferior vena cava
Indication: Access for long term administration of TPN, Meds, fluids, blood products or chemotherapy
Peripherally Inserted Central Catheter (PICC)
Purpose: Maintenance of normal cerebral perfusion pressure (CCP) and early ID or increased ICP
Keep head of bed @ 30 degrees
Normal ICP is 5-15mm Hg
Intracranial Pressure Monitoring (ICP)
Name some factors that will increase ICP (Intracranial Pressure).
Lower Head of Bed (Trendelenburg)
Pain
Noxious Stimuli
Coughing
Range of ICP that is cause for concern?
Abnormal range for ICP?
Range of moderate hypertension (HTN) ICP?
Severe life threatening intracranial HTN?
15-20mm Hg
> 20mm Hg
20 - 40mm Hg
> 40mm Hg
Placement: Subarachnoid space via burr hold, placed by MD.
Indication: Short term use if cerebral edema prevents use of other devices.
PT: Rare for PT to get this patient into an upright position. If drug induced coma, pt will not waken from coma stimulation.
ICP Bolt
Placement: Anterior horn of the lateral ventricle via a burr hole. Place by an MD (Gold Standard for measuring ICP)
Indication: Drainage or sampling of CSF, monitor ICP
PT: Needs to look for color change in drained CSF. Normal clear, pinkish, or straw colored.
Ventriculostomy (intraventricular catheter)
Placement: Inflatable sleeves applied to leg (full leg or just lower portion)
Indication: Promote venous return and prevent DVTs
PT: Contraindicated over a leg with fracture, open wound, acute cellulitis and leg with DVT
Sequential Compression Device
Placement: Given to patient at bedside. Patient breathes in through device.
Indication: To assist with deep breathing in hope to prevent pulmonary complications during hospital stays.
PT: Encourage pt to use often in bed.
Incentive Spirometer
Placement: Placed at surgical site. Can be gravity assisted or suctioned.
Indication: Used to drain wound of edema and blood.
Constavac
Placement: Placed at a surgical site. Placed by MD
Indication: Drainage of local edema/Blood
PT: Ensure device does not fall out. May pin to patient’s gown. But don’t forget to unpin!!
Jackson Pratt (JP)
Placement: Colon is surgically opened and brought to the abdominal surface, bag placed by RN after surgery.
Indication: Bowel elimination when colon is obstructed or not functioning, there is a need for diversion of decal material
PT: Gait belt should be placed superior above site. Consider emptying bag before start of treatment
Colostomy/Ileostomy
Placement: Rectum. Placed by RN
Indication: Rectal drainage, collect liquid stool, prevent skin breakdown secondary runny stool
Rectal Tube / Rectal Pouch
Placement: Bladder. Place by RN
Indication: Bladder drainage
PT: Must be taken with patient always. Ask nurse for help when it needs to be drained.
Urinary or Foley Catheter
Placement: Surgically placed in chest between ribs. Place by MD
Indication: Promotes normal intrapleural pressures/mechanics by 1) removing air or fluid from pleural space 2) Prevent re-entry of air/fluid 3) re-inflate a collapsed lung
Chest Tube
Placement: Where needed
Indication: Used for suction of saliva, mucous, blood, or bodily fluids.
PT: This is your friend! Use it!
Suction (Yankauer suction)
Placement: PVC tube in placed in trachea through an opening in the neck (stoma). Placed by an MD
Indication: Mechanical ventilation, prolonged ventilatory support, after a laryngectomy, tracheal resection, other head/neck surgeries.
PT: If patient is off of ventilator, be cautious of cough due to projectile
Tracheostomy (Trach)
Placement: PVC tube placed in trachea via nose or mouth. Placed by MD
Indication: Used to relieve airway instruction, prevent aspiration, facilitate tracheal suction, mechanical ventilation.
PT: Should know if pt is weaning.
Endotrachial Tube (ET Tube)
Placement: Surgically placed in the stomach/jejunum. Place by MD
Indication: Enteral feeding. Small intestine drainage, gastric drainage.
PT: Watch placement of gait belt and hands to prevent pulling out lines.
PEG/PEJ Tube
Percutaneous Endoscopic Gastostomy
Percutaneous Endoscopic Jejunostomy
