3630A WEEK 1

Vocabulary practice flashcards covering central venous access devices, electrolyte imbalances, enteral tubes, and parenteral nutrition from Week 1.

Peripherally Inserted Central Catheter (PICC)

A medium-term central venous access device that enters the body on the upper arm and terminates in the superior vena cava, which can be inserted and removed by specially trained registered nurses.

Non-Tunneled CVAD

A shorter-term central venous catheter commonly used in critical care that enters directly at a vessel site (internal or external jugular, subclavian, or femoral vein) with the catheter exiting straight from the insertion site into the superior vena cava.

Tunneled CVAD

A long-term central venous catheter (such as a Hickman or Broviac) whose proximal end is tunneled subcutaneously from the vein entry site to an exit site and secured with an antimicrobial Dacron cuff.

Implanted CVAD (Port-A-Cath)

A long-term central venous access device surgically implanted under the skin in the chest, abdomen, or inner forearm that requires access using a specialized needle.

Heparin Lock

A heparin flush instilled and left inside a central venous catheter lumen during periods of non-use to maintain patency and prevent thrombus formation.

Air Embolism

A serious CVAD complication presenting with sudden chest pain, shortness of breath, and dizziness, managed immediately by placing the patient in left lateral Trendelenburg position and administering oxygen.

Cl -

An extracellular anion with a normal range of $95\text{--}105\,mmol/L$ that helps maintain blood pressure, volume, and pH balance by shifting with sodium and inversely with bicarbonate ($\text{HCO}_3^-$).

Hypomagnesemia

A serum concentration $0.65\,mmol/L$ characterized by tachycardia, hypertension, tremors, paresthesia, hyperreflexia, positive Chvostek's and Trousseau's signs, and confusion.

Hypermagnesemia

A serum concentration of $1.05\,mmol/L$ characterized by bradycardia, hypotension, muscle weakness, decreased deep tendon reflexes, and lethargy progressing to coma.

Chvostek's

Physical exam indicators of neuromuscular excitability linked to hypocalcemia and hypomagnesemia, seen as facial twitching upon tapping the facial nerve

Hypercalcemia

A total serum level of $2.55\,mmol/L$ presenting clinically with diminished deep tendon reflexes, nausea, vomiting, bone pain, fractures, weakness, and altered mental status.

Hypocalcemia

A total serum level of $2.20\,mmol/L$ manifested by perioral paresthesia, hyperreflexia, muscle cramps, positive Chvostek's and Trousseau's signs, and seizures.

Phosphate ($\text{PO}_4^{3-}$)

A predominantly intracellular anion with a reference range of $0.80\text{--}1.33\,mmol/L$ essential for neuromuscular function, red blood cell production, and skeletal mineralization, exhibiting an inverse relationship with calcium.

Enteral Nutrition

The delivery of liquefied nutrition directly into the functioning gastrointestinal tract through an access tube when oral intake is inadequate to sustain nutritional requirements.

Orogastric Tube (OG)

A large-bore tube inserted through the mouth ending in the stomach, commonly utilized in emergency or intensive care units for unconscious patients requiring decompression or suction.

Nasogastric Tube (NG)

A tube inserted through the nose into the stomach intended for short-term use ($< 4\text{--}6\text{ weeks}$) for feeding or gastric decompression.

Gastrostomy Tube (G-Tube / PEG)

A tube placed surgically or endoscopically through the abdominal wall directly into the stomach intended for long-term enteral feeding.

Small Bowel Feeding Tube (SBFT)

A small-diameter enteral access tube passed through the nose with the distal tip terminating post-pyloric in the duodenum to bypass the stomach and reduce aspiration risk.

Jejunostomy Tube (J-Tube)

A large-diameter enteral tube placed surgically through the abdominal wall into the jejunum for long-term feeding that bypasses the stomach.

Bolus Enteral Feeding

A delivery method mimicking regular meals wherein formula is administered over a $30\text{--}60\text{ minute}$ window every $3\text{--}6\text{ hours}$.

Continuous Enteral Feeding

A method of administering enteral formula non-stop across a continuous $24\text{-hour}$ cycle via an electronic infusion pump.

Cyclical Enteral Feeding

An enteral feeding regimen administered on a scheduled basis over an $8\text{--}16\text{ hour}$ period during the day or night.

Lopez Valve

A three-way stopcock device attached to an enteral tube that contains a medication port and universal feeding adaptor to allow irrigation and medication delivery without opening the line.

Gastrointestinal Suctioning

The removal of gas and fluid secretions from the stomach via an access tube using negative pressure (typically $40\text{--}60\,mmHg$, up to $80\,mmHg$) to alleviate distention and prevent aspiration.

Re-feeding Syndrome

A gastrointestinal complication associated with enteral feeds caused by nutrient reintroduction after a period of malnutrition characterized by hypophosatemia and hypokalemia

Aspiration Pneumonia

A lung infection resulting from entry of formula or gastric contents into the airway, presenting with fever, leukocytosis, tachypnea, hypoxemia, adventitious sounds, and cough.

Parenteral Nutrition (PN)

The intravenous administration of hypertonic nutrition (amino acids, dextrose, electrolytes, vitamins, and minerals) directly into the blood when the gastrointestinal tract cannot be utilized.

Central Parenteral Nutrition (CPN)

Parenteral nutrition infused into a large high-flow central vein via a CVAD or PICC, allowing rapid dilution of hypertonic, high-caloric formulas for long-term therapy.

Peripheral Parenteral Nutrition (PPN)

Short-term intravenous nutritional therapy delivered through a peripheral venous catheter using lower osmolarity solutions, which carries risks of phlebitis and fluid overload.

Dumping Syndrome

A condition that occurs when food moves too quickly from the stomach to the small intestine, often resulting in symptoms such as nausea, vomiting, diarrhea, and abdominal cramps.

Trousseau's Signs

A clinical sign indicating the presence of hypocalcemia, characterized by muscle spasms or tetany when a blood pressure cuff is inflated or a tourniquet is applied.

PIV

A type of intravenous access using a peripheral intravenous catheter, often used for fluid and medication administration.

CVAD

a long, thin tube placed in a large vein, typically used for administering medications, fluids, or nutritional support, and for drawing blood.

Mg

an essential mineral important for numerous biochemical processes, including muscle function, nerve transmission, and the regulation of heart rhythm.

Ca

An essential mineral vital for bone health, muscle contraction, and nerve signaling.

Hyperphosphatemia

a total serum level of 1.33 mmols that presents as hypercalcemia, hyperkalemia, depression, anxiety, and muscle cramps

hypophosphatemia

total serum of 0.80 mmols that presents as confusion, weakness, decreased GI motility and can be caused by alcohol withdrawl

Blocked tubes

needs to be flushed with pancreatic enzymes disolved in sodium bicarbonate to aid digestion and prevent malabsorption.

Removing Enteral Tube

clamp for trial, if nausea and vomiting dont decrease over time, flush with sterile water and then remove