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HSIP 1000 > Week 6 Content > Flashcards

Week 6 Content Flashcards

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1
Q

Why must sterile asepsis be maintained when inserting drainage tubes?

A

Because closed cavities of the body are sterile and must remain so to prevent infection.

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2
Q

What happens if a sterile portal of entry contacts a non-sterile surface?

A

It immediately becomes non-sterile, increasing the risk of infection.

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3
Q

How should drainage tubes and collection bags be positioned?

A

Below the cavity being drained to allow gravity to promote fluid flow.

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4
Q

What should be avoided to ensure continuous drainage?

A

Kinks, coils, clamping without a doctor’s order, and allowing the patient to lie on the tubing.

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5
Q

Why should the site be cleansed before accessing a drainage tube?

A

To prevent microorganism introduction, reducing infection risk.

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6
Q

What determines whether fluid flows through a tube?

A

A pressure difference between the two ends of the tube.

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7
Q

How does the height of a liquid column affect flow rate?

A

A higher column increases pressure and speeds up flow, while a lower column slows it down.

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8
Q

How does tube diameter affect fluid flow?

A

A larger diameter increases flow rate, while a smaller diameter reduces it.

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9
Q

Why does tube length impact fluid flow?

A

Longer tubes create more friction, slowing down flow; shorter tubes allow faster flow.

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10
Q

What is viscosity, and how does it affect fluid flow?

A

Viscosity is a fluid’s resistance to flow; higher viscosity slows flow, while dilution or increased pressure can speed it up.

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11
Q

What are the 4 factors that affect the flow of fluid through tubes?

A

Viscosity, Diameter, Length, Pressure difference.

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12
Q

What is a nasogastric (NG) tube?

A

A flexible plastic tube inserted through the nostrils, down the nasopharynx, and into the stomach or upper small intestine.

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13
Q

How is NG tube placement confirmed before use?

A

With an X-ray.

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14
Q

What are the two main purposes of an NG tube?

A
  1. Deliver nutrients via a feeding pump. 2. Remove gastric contents.
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15
Q

Why are NG tubes used for feeding?

A

They help patients with swallowing difficulties or those needing extra nutrition.

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16
Q

How does an NG tube help remove gastric contents?

A

By draining the stomach through gravity or suction to prevent nausea, vomiting, and gastric distension or remove toxins.

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17
Q

How is an NG tube secured to prevent accidental removal?

A

It is fastened with a nose clip, taped, and pinned to the patient’s gown.

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18
Q

How can NG tubes cause discomfort, and what helps reduce it?

A

They irritate nasal mucosa; securing the tube and pinning it to the gown can reduce excess movement and discomfort.

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19
Q

Why do NG tube patients tend to mouth breathe, and what can help?

A

One nostril is blocked, causing dry mouth. Mouth care, rinsing with cold water/mouthwash, or sucking on ice chips (if allowed) can help.

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20
Q

What should you do if a patient with an NG tube experiences abdominal pain, nausea, or vomiting?

A

Report it immediately, as the drainage flow may be obstructed and the tube might need irrigation.

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21
Q

Why should patients with an NG tube never lie completely flat?

A

It increases the risk of aspiration; the head of the bed should always be raised at least 30 degrees.

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22
Q

Why should an NG feeding tube be labeled?

A

To ensure proper identification and avoid misuse.

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23
Q

What is urinary catheterization?

A

The insertion of a catheter through the urethra into the bladder to drain urine.

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24
Q

When is urinary catheterization required?

A
  • Acute urinary retention
  • Monitoring intake/output
  • Preoperative management
  • Healing of sacral/perineal wounds in incontinent patients
  • Prolonged bedrest
  • End-of-life care
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25
What are CAUTIs, and why are they a concern?
Catheter-associated urinary tract infections are common healthcare-associated infections (HAIs) that increase morbidity, mortality, hospital costs, and length of stay.
26
What is the main risk factor for developing a CAUTI?
Prolonged use of a urinary catheter.
27
What are common signs and symptoms of a CAUTI?
- Fever, chills - Lethargy - Lower abdominal/back pain - Urgency, frequency, painful urination - Hematuria - Mental status changes (confusion, delirium)
28
How can CAUTIs be prevented?
- Use sterile technique for insertion - Insert only when necessary and remove ASAP - Use the narrowest tube size possible - Clean urethral meatus daily - Maintain a closed drainage system - Avoid kinks/blockages in tubing - Secure the catheter properly
29
What are the two types of urethral catheterization?
Intermittent (single-lumen) and Indwelling (double- or triple-lumen).
30
When is an intermittent catheter used?
- Immediate relief of urinary retention - Long-term bladder management - Obtaining sterile urine specimens - Assessing post-void residual urine
31
When is an indwelling catheter used?
- Urinary elimination support - Accurate urine output measurement - Skin breakdown prevention - Wound management - Post-surgical repair of urinary structures - Instilling irrigation fluids or medications
32
What is the recommended catheter size for adults?
- Females: 12-16 Fr - Males: 14-16 Fr
33
How should a urinary drainage bag be positioned?
Below the bladder level to allow urine flow and prevent backflow.
34
When should a urinary catheter be removed?
As soon as it is no longer necessary, ideally within 24 hours post-surgery.
35
What should a patient do after catheter removal?
- Increase/maintain fluid intake - Void within 6-8 hours - Report burning, pain, small urine volume, or difficulty voiding - Monitor for CAUTI signs
36
What is a tracheostoma?
An artificial opening made in the trachea just below the larynx to create an airway.
37
When are tracheostomy tubes used?
- Airway maintenance - Ventilation - Secretion removal - Alternate airway (e.g., after laryngectomy)
38
What are the types of tracheostomy tubes?
- Soft plastic, hard plastic, or metal - Cuffed (prevents aspiration and air leaks) or non-cuffed - Outer cannula, inner cannula, and obturator
39
Why is humidification needed for tracheostomy patients?
Air bypasses the upper airway, so it is no longer filtered and humidified.
40
What position should a tracheostomy patient be in?
At least a 30-degree angle to facilitate breathing and lung expansion.
41
Why do tracheostomy patients need frequent suctioning?
They produce more secretions and may not be able to clear them with coughing.
42
Can a tracheostomy patient speak?
No, unless they have a speaking device, since air does not pass over the vocal cords.
43
What are early complications of tracheostomies?
- Hemorrhage - Pneumothorax - Subcutaneous emphysema - Cuff leak - Tube dislodgement - Respiratory/cardiovascular arrest
44
What are late complications of tracheostomies?
- Airway obstruction - Fistulae - Infection - Aspiration - Tracheal damage/erosion
45
What emergency supplies must be at the bedside of a tracheostomy patient?
- Suction and oxygen equipment - Spare tracheostomy tubes (same and smaller size) - Obturator and spare inner cannula - 10 ml syringe - Tracheal tube exchanger & dilators - Sterile gloves and gauze - Water-soluble lubricant
46
Why must emergency equipment accompany tracheostomy patients during transport?
To be prepared for any airway emergencies, such as tube dislodgement.
47
What is a chest tube (thoracic catheter)?
A sterile tube with drainage holes inserted into the pleural space to remove air or fluid and restore negative pressure.
48
Why is negative pressure important in the pleural cavity?
It allows for lung expansion and prevents lung collapse at the end of exhalation.
49
When is a chest drainage system required?
When a large amount of air or fluid enters the pleural space and cannot be absorbed by the body.
50
How does a chest drainage system work?
It is a closed, airtight system that removes air/fluid while preventing re-entry into the pleural cavity.
51
Where is a chest tube placed for air drainage?
Above the second intercostal space at the mid-clavicular line.
52
Where is a chest tube placed for fluid drainage?
At the fourth to fifth intercostal space at the mid-axillary line.
53
What are some conditions requiring a chest tube?
- Pleural effusion - Pneumothorax - Hemothorax - Tension pneumothorax - Traumatic pneumothorax - Cardiac tamponade
54
Where should the chest drainage system be positioned?
Below the drainage site and secured upright (e.g., attached to the floor or an IV pole).
55
What are the three chambers of a traditional chest drainage system?
1. Collection chamber – Collects and measures pleural drainage. 2. Water-seal chamber – One-way valve prevents air re-entry; tidaling indicates patency. 3. Suction control chamber – Regulates suction (wet or dry system).
56
What is tidaling in a water-seal chamber?
The rise and fall of water with breathing, indicating that the chest tube is patent.
57
What does continuous bubbling in the water-seal chamber indicate?
A possible air leak.
58
How does a wet suction system work?
Suction is controlled by the water level in the suction control chamber, typically set at -20 cm for adults.
59
How does a dry suction system work?
It uses a self-regulating mechanism to maintain consistent suction and responds to air leaks.
60
What must be done if suction is discontinued?
The suction port must remain open to prevent tension pneumothorax.
61
What responsibilities does a healthcare provider have for a chest tube patient?
- Assess the patient regularly. - Ensure the drainage system is functioning. - Check for safety/emergency equipment at the bedside. - Promote lung expansion with deep breathing, coughing, position changes, and ambulation.
62
What is an ostomy?
A surgically created opening from the urinary tract or intestines to reroute effluent (feces, urine, or mucus) outside the body through a stoma.
63
What is a stoma?
An artificially created opening for an ostomy that protrudes above the skin, is pink/red, moist, round, and has no nerve sensations.
64
Why are ostomy surgeries performed?
To remove diseased parts of the bowel or urinary system due to conditions like cancer, inflammatory bowel diseases, perforations, trauma, or radiation complications.
65
What is the difference between a colostomy and an ileostomy?
- Colostomy: Created from the colon (large bowel) to divert fecal matter. - Ileostomy: Created from the ileum (small bowel) to divert fecal matter.
66
What is a urostomy (ileal conduit)?
A stoma created using a piece of the intestine to divert urine outside the body by attaching the ureters to the intestinal segment.
67
What conditions may require an ostomy?
- Bowel or bladder cancer - Crohn’s disease or colitis - Perforation of the colon - Diverticulitis - Trauma - Necrotic bowel - Radiation complications
68
What are the two types of pouching systems for ostomy patients?
1. One-piece system: The pouch and flange are combined. 2. Two-piece system: The pouch and flange are separate but connect securely.
69
Why must a pouching system be sealed properly?
To prevent leakage, protect peristomal skin from irritation, and contain odor.
70
What factors determine the choice of a pouching system?
Type of stoma, stoma location, skin condition, patient ability, and personal preference.
71
How often should an ostomy pouching system be changed?
Every 4-7 days or sooner if it leaks, odor is present, excessive skin exposure occurs, or the patient experiences itching/burning.
72
Can patients with ostomies swim or shower?
Yes, they can swim and shower with the pouching system on.
73
What is a continent ileostomy?
An internal pouch created from the ileum, requiring flushing multiple times a day instead of using an external pouch.
74
What is an ileoanal ostomy?
A pouch created above the anal sphincter from the ileum, allowing waste collection without an external pouch.
75
What are the two types of internal urinary diversions?
1. Orthotopic neobladder: A reconstructed bladder placed in the normal bladder position. 2. Continent urinary reservoir: A pouch created from the intestine, requiring catheterization for urine drainage.
76
What physical conditions may affect a patient’s ability to manage ostomy care?
Arthritis, vision impairment, Parkinson’s disease, and post-stroke complications.
77
What emotional challenges may ostomy patients face?
- Self-esteem and body image concerns - Anxiety about elimination patterns - Quality of life and intimacy issues
78
How can healthcare providers support ostomy patients emotionally?
- Provide referrals to wound/ostomy nurses and social workers - Encourage support group participation - Be mindful of non-verbal cues and avoid showing discomfort toward the ostomy or its odor

HSIP 1000 (5 decks)

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