Patient Intervention Flashcards
(27 cards)
Hypoxemia
Inadequate level of oxygen in arterial blood.
eg: PaO2 is < 60mm Hg/ Hb saturation is < 90%
Hypercapnia
CO2 retained in arterial blood
Hazards of oxygen administration
Mild oxygen toxicity : reversible tracheobronchitis
Severe oxygen toxicity: irreversible parenchymal lung injury
What happens when excessive amount of oxygen is present in the blood of patient with COPD?
*Depress the respiratory drive and pt may stop breathing.
*Because they have chemoreceptors that does not respond respond to the stimuli of CO2
* Their respiratory stimulus is hypoxemia.
Oxygen delivery systems
wall outlet: 60 to 80 lb per square inch
Full tank: 2000 lb per square inch
Flow rate of oxygen through Nasal Cannula
Adults: 1-4 LPM
Children: 1/4 to 1/2 LPM
Flow rate of Nasal catheter
1-5 LPM
Flow rate of oxygen Face mask
at least 5 LPM
*Non rebreathing mask - 100% oxygen
*Partial rebreathing mask - 60% - 90%
* Venturi mask - 24% - 50% by mixing room air and O2
* Aerosol Mask - 60% - 80% O2 mixed with water particles
Types of Nasogastric tubes
- Levin
- Sump
- Nutriflex
- moss
- Sengstaken- Blakemore
Levin tube
Single lumen, plastic tubes passed through the nose into the stomach.
Use: gastric decompression
Sump tube
2 Lumen, Radiopaque tube with a plug pigtail that lets airflow to the stomach
Use: Drain fluid from the stomach
Nutriflex
1 lumen, mercury weighted tip; gastric secretion activated lubricant.
Use: Feeding
Moss tube
3 lumen
one has inflatable balloon to anchor it in the stomach;
second lumen is used for aspiration of fluids;
third lumen for duodenal feeding.
Sengstaken- Blakemore
Thick catheter with two lumens of balloons to exert pressure on the esophageal varices. Third lumen is used for lavage and to monitor hemorrhage.
Types of NE Tubes
- Cantor
- Harris
- Miller-Abbott
Cantor tube
Single lumen; Long tube with a small mercury-filled bag at the end; contains drainage holes for aspiration.
Use: relieves obstruction in the small intestine.
Harris tube
Single lumen
Mercury weighted tube passed through the nose and carried through digestive tract by gravity.
Use: Gastric & intestinal decompression
Miller- Abbott tube
2 lumen; radiopaque tube.
Long small-caliber catheter; one is perforated metal tip and other has a collapsible balloon.
Use: Decompression
Gastrostomy tube
- A tube placed through surgical opening from inside of the stomach to the abdominal wall.
- Chances of infection; use sterile gloves if contact with open area is needed.
Central Venous Catheter(CVC)
-Used in patients with long-term meds administration, blood transfusion, hyperosmolar solutions or Total Parental solution(TPN).
-Also for measuring Central venous pressure(CVP)
-Placed at Brachiocephalic vein at the junction of SVC or at SVC itself.
- placement visualized with mobile radiography or C-arm fluoro at the time of insertion.
- The CVC line should be just medial to the anterior border of 1st rib.
Large gauge catheter
Inserted to large peripheral vein in the arm.
- Parenteral solution with a combination of lipid emulsion and amino acid is administered
Total parenteral nutrition(TPN)
- Delivered through Central vein
-TPN is hyperosmotic; so would damage the intima of peripheral vein. - Fluid imbalance occurs if TPN is administered too rapidly; so administration is controlled by pump.
Types of central venous catheters
Tunnel type:-
1. Hickman catheter
2. Broviac Catheter
Others:-
3. Peripherally inserted central catheter(PICC)
4. Groshong catheter
Indications for suctioning
- Profuse vomiting in a patient who cannot change position voluntarily.
- Audible rattling or gurgling sound from pt’s throat
- signs of respiratory distress
