Deliver meds/fluids Aka "Hep lock" - b/c used to be flushed by herparin Air filter on IV tubing for PFO to decrease risk of air bubbles
Extended antibiotics/meds, chemotherapy, or TPN (total parenteral nutrition) Usually in cephalic, basilic or brachial vein w/ tip advanced through larger veins until it rests in SVC or cavo-atrial junction
PT implications of IV/PICC
Trace all IVs to the origin to avoid pulling them out Avoid taking BP on PICC side (due to increased risk of phlebitis) If tip of PICC is advanced too far into right atrium, can cause arrhthymias due to irritation; location confirmed by chest film
nasogastric thru nose into stomach, for patients who can't swallow, short term
into stomach thru abdomen, for patients who can't swallow aka PEG tube, long term
into jejunum thru abdomen if stomach cannot digest; decreased risk of aspiration, long-term/permanent
removes waste from blood stream for pts w/ renal failure, uses arteriovenous fistula or venous access through a central line, every other day 3-4 hours
continuous venovenous hemofiltration: removes waste products continuously to eliminate large fluid shifts
chest tube considerations
if on wall suction, attach it to portable suction to mobilize drains by gravity -> keep drainage container below insertion site bubbling in container could indicate air leak or pneumothorax if pulled out apply pressure over site and tell a nuse or doctor
vacuum assisted closure bandage, uses suction to draw out fluid from the wound and bring more blood to the area decreases edema increases perfusion and promotes granulation tissue formation
foley catheter/surgical drain considerations
Secure drain to clothing to reduce friction at insertion site (to decrease risk of UTI) add'l for foley catheter: place low when working with pts to promote drainage, don't tip collection canister as it's used to carefully measure urine
soft flexible catheter inserted through a vein into the pulmonary artery, used to provide continuous measurements of pulmonary artery, right atrium, right ventricle, and pulmonary capillary wedge pressure
catheter placed in artery to monitor real-time BP and obtain samples for ABGs. NOT used to administer medication (meds go in veins). usually in radial, but sometimes in brachial or femoral a.
chest tube/pigtail catheter
Catheter/drain inserted through the thorax to remove air and fluids from the pleural space, to prevent air or fluid from reentering the pleural space, or to reestablish normal intrapleural and intrapulmonic pressures.
IV access site into one of the major blood vessels through which hypertonic fluids may be given.
jackson pratt drain
aka grenade drain. collects wound drainage in a bulblike device that is compressed to create gentle suction. It consist of perforated tubing connected to a portable vacuum unit. After surgical procedure, surgeon places one end of drain in or near area to be drained. The other end passes through skin via a separate incision. These drains are usually sutured in place.