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purposes of tubes and drains
to remove fluid
to instill fluid
to measure smth
principles of tubes and drains
closed cavities are sterile
gravity promotes flow
drainage will flow if there is no blockage
pre-cleansing reduces the chances of contamination
rules for clamping
do not clamp tubes without dc’s order
factors that affect flow of fluid through tubes
pressure difference (greater diff = more flow)
diameter (greater diameter = more flow)
length (longer tube = more friction to pass = less flow)
viscosity (more thickness = less flow)
care measures for NG tubes
always have the tube anchored to smth (pt gown, hand)
to prevent aspiration have pt in semi-fowlers
T-tubes purpose
maintains patency of the CBD after surgery and permits drainage of bile until edema of the CBD decreases
care measures for t-tubes
facilitate drainage via gravity positioning pt to semi-fowlers
monitor bile bag for unusual drainage
portable wound suction purpose
systems that exert a gentle, even pressure to remove drainage and debris from a wound
care measures for portable wound suctions
evacuators/receptacles are pinned to pt gown or attached to bed/stretcher sheet
evacuator is ALWAYS placed below the drainage site
observe for sudden massive discharge or bleeding
ostomy appliances purpose
an opening is made to allow the passage of urine or feces by bringing a portion of the intestine or ureter to the outer surface of the abdominal wall
care measures of ostomy appliances
sensitive to pt’s emotional needs
good aseptic technique
closed chest drainage systems / chest tubes purpose
permit drainage of air / fluid from the plural space and to prevent their return flow.
help re-expand the lung by re-establishing negative pressure.
care measures for chest tubes
drainage system must be kept parallel to the floor and lower than the chest
keep the tube intact
keep the tube site sterile
urinary drainage systems
Condom Drainage
Indwelling Urinary Catheter (Foley)
Suprapubic Catheter
Condom Drainage and purpose
applied externally to the penis and connected to a urine drainage bag
aid in urinary incontinence noninvasively
Indwelling Urinary Catheter (Foley)
inserted into the bladder through the urethra and held in place by a balloon filled with sterile water
helps with incontinence
Suprapubic Catheter
inserted into the bladder through a surgical opening the abdominal wall
allows for urine drainage if the urethra is blocked or the bladder is removed or damaged
care measures for urinary drainage systems
when disconnected consider risk of infection
parenteral meaning
introduction of a substance into the body other than through the GI system
eg. parenteral
Needles
syringes
cannulas
intravenous
needle stick principles
never recap needles by holding the cap
recap by scooping the cap up with the needle
intravenous therapy purpose
to restore and maintain fluids in the body
Electronic Infusion Devices (EIDs) / IV Pumps
control and regulate the infusion rate by alarming when there is infiltration or when the infusion is complete
how to deal with alarms
read the message
get assistance
tractions and purpose
mechanical device that uses weights and pulleys to control pain from muscle spasm, etc
types of tractions
skin traction
skeletal traction
fitted traction
care measures for tractions
never interrupt skeletal or skin tractions
never remove weights without confirmation
weights must hang free
pt has good body alignment
no rope kinks
Cardiac Monitoring Devices
Electrocardiography (ECG) monitors
Ventilators/Tracheostomies
tracheostomy is an external surgical opening into the trachea to allow air to bypass the upper respiratory tract
mechanical ventilation is a type of life support that uses a machine to help a patient breathe