WEEK 6 - Tubes and Drains

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

1. Condom Drainage

2. Indwelling Urinary Catheter (Foley)

3. 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