Medical Devices PPT Flashcards Preview

Hannah RAD III > Medical Devices PPT > Flashcards

Flashcards in Medical Devices PPT Deck (61):
1

What is another name for a chest tube?

Thoracostomy or Intrapleural Tube

2

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)

3

Purpose of a chest tube

Drain intrapleural space & mediastinum
– Fluid/air

4

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

Pneumothorax
Hemothorax
Pleural effusion
Empyema

5

What is Empyema?

Type of pleural effusion where fluid is affected

6

Negative pressure is disturbed

Lungs fail to expand or collapse
Tube is inserted to reestablish pressure

7

Chest tube attaches to

Watersealed drainage unit

8

Collects air/fluid to reestablish

the correct Intrapleural pressure & allows lungs to
expand

9

Tube remains below water level to

Maintain seal

10

Tube ends in a chamber containing

Sterile water or sterile saline

11

Patient inhales & air/fluid are drawn into

Dainage tube and ChamberInto

12

Various water-sealed systems are

Disposable

13

***Mediastinal drain (small chest tube)

After cardiac surgery
– Drains residual blood from _Mediastinum_ to
prevent accumulation around _Pericardium_

14

2 Chest tubes

Y connector joins tubes near patient’s body and continues to drainage apparatus

15

How to Handling Chest Tubes

Keep tubing from pleural cavity to drainage chamber as straight at possible – prevent tension from being placed on tube
• Do not empty water-sealed chambers or raise them – it must remain below the patient’s chest @ all times
• Do not clamp chest tube
• If chamber is bubbling, notify patient’s nurse
immediately (indicates possible leak)
• Patient’s breathing changes or complains of chest pain, notify patient’s nurse immediately

16

CXR Images

Before and after insertion
– Proper insertion
• Verify tube can be removed
• Initial images to confirm lung expansion
• 2 hours after clamping to verify continued expansion
– After removal to confirm lung expansion

17

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

Mechanical ventilation or oxygen delivery
Upper airway obstruction
Impending gastric acid reflux or aspiration

18

Endotracheal tube (ETT) inserted

Through mouth into trachea (or through tracheostomy)
– After placed in trachea, cuff is inflated to keep airway open
– Establishes airway; prevents aspiration of foreign
objects

19

Where is the proper placement of the endotracheal tube?

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

20

CXR to determine

Proper placement
– 20% require repositioning

21

Atelectasis is

Collapsed lung

22

***If Endotracheal tube (ETT) tube is inserted too far

Enters the right bronchus causing a collapse of left lung or atelectasis

23

If Endotracheal tube (ETT) tube is too high

Air enters the stomach and regurgitation leads to aspiration pneumonia

24

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)

25

***What are some of the uses for the catheter mentioned in the previous question?
(Central venous catheter
Venous access device
Hickman/Groshong)

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

26

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

SVC approximately 2 to 3 cm above the right atrial junction
Hickman & Broviac

27

***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

28

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

Pulmonary arterial or PA line

29

***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

30

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

Radiologist
Nurse
Specially trained technologist

31

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

Prolonged antibiotic treatment
Home health care for extended treatment
Chemotherapy
Nutrition

32

PICC Line stand for

Peripherally Inserted Central Catheter

33

***Where is PICC line inserted?

Into patient’s arm and advanced into a central
vein (Subclavian to SVC)
• Basilic, cephalic or median cubital veins

34

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

35

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

Huber needle

36

Implanted port

Frequent intravenous medications or transfusion
– Plastic, titanium or stainless steel
– Implanted into _Subcutaneous_ tissue

37

***Catheter from port inserted into

Subclavian or internal jugular vein

38

Right Side Approach for Line Placement

Follow course of subclavian vein in a lateromedial direction
Right brachiocephalic vein
– SVC to right atrium
• Catheter is _Right_ of vertebral column
• Does not cross _Midline___

39

Left Side Approach for Line Placement

Slightly longer catheter is required
Advanced lateromedially to left subclavian vein to
left brachiocephalic vein
– Vein courses horizontally
– Catheter crosses midline from left to right ending in SVC

40

What are the primary uses for a nasogastric tube?

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

41

What is the most common NG tube?

Levin tube: Single lumen with several holes near its tip
Sump tube: double-lumen tube
• Second opening is referred to as “_Pigtail_”
– Blue extension off of proximal end of tube

42

3 other types of NG tube are

Nutriflex tube
Moss Tube
Sengstaken-Blakemore (S-B)

43

Nutriflex tube

• Primarily for feeding
• Mercury-weighted tip

44

Moss Tube

• Triple-lumen tube
• One end has inflatable balloon to anchor in
stomach; 2nd lumen is for aspiration of fluid; 3rd
lumen is for duodenal feeding

45

Sengstaken-Blakemore (S-B)

• Triple-lumen tube
• 2 lumens with balloons
– Inflated for pressure on varices
• 3rd lumen used for lavage and monitors hemorrhage
– Pressures must be maintained @ all times
– Requires nurse to be with patient @ all times
– ICU patients

46

NE tube also called

Nasoenteric Feeding Tube
Entriflex or Dobhoff tube
• Narrow lumen tube

47

What are some uses for the nasoenteric feeding tube?

• Intestinal decompression
• Introduction of mercury after insertion
Feeding and hydration of patient
Contrast administration
Not used with SUCTION

48

***Nasoenteric feeding tubes are.........and more ................ than NG tubes.

Thinner
Flexible

49

NE tubes can stay in for

a longer period of time

50

NE tubes are positioned @

the level of 3rd portion of duodenum

51

3 Most common NE tubes are

Cantor: single-lumen
– _Harris_: single-lumen
– _Miller_: double-lumen

52

What is a PEG tube?

Gastric feeding tube
Surgical creation of opening into stomach
Percutaneous Endoscopic Gastrostomy – most common type

53

PEG tube placed

From inside of the stomach to external abdominal wall

54

What is the purpose of PEG tube?

Feeding a patient who cannot tolerate oral intake of
food
• Temporary/permanent

55

PEG tube is closed off after feeding with

clamp or plug-in adapter to prevent leakage of contents
– Tube is coiled and taped in place

56

PEG is inserted through

small incision into stomach or jejunum
– Endoscopy procedure
– Surgery

57

PEG tube is used for

long term nutrition

58

Defecogram also called

Defecography
Evaluation proctography
Dynamic rectal exam

59

Perform Defecogram

Defecation dysfunction
• No patient prep
• Instill barium directly into rectum using special
injector
• Patient seated laterally on a commercially
available radiolucent toilet in front of fluoro unit

60

Images acquired during Defecogram procedure

Lateral projection @ 1 to 2 images per second
(rapid sequence)
– Video recording may be done

61

Images evaluate of Defecogram

Measurements of anorectal angle & angle between long
axes of anal canal & rectum