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27 Cards in this Set
- Front
- Back
Levin (nasogastric tibe)
description/use |
single lumen NG tube.
used to remove gastric contents via intermittent suction or provide tube feedings |
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Salem Sump (nasogastric tube)
description/use |
double lumen NG tube with an air vent(pigtail)
*air vent is not to be clamped and is to be kept above stomach level* *if leakage occurs through the air vent, instill 30ml of air into vent and irrigate the main lumen with NS per agency policy |
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Determining NG placement
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1.most reliable method is x-ray. should be performed after initial placement.
2. determine tube placement every 4 hours b4 adm of food and meds. 3. aspirating gastric contents and measuring PH (should be 4 or lower) 4. Insert 5 to 10 ml of air into NG tube and listening, should hear a gush nof air over the stomach with a stethoscope. |
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checking residual of NG placement
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1. Check residual every 4 hours b4 feeding and meds.
2. Aspirate all stomach contents measure amount. 3. Reinstill residual feeding to prevent electrolyte and fluid losses, unless the volume exceeds 100ml, appears abn. *if residual is less than 100 feeding is being administered |
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irrigating NG
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1.perform every 4 hours to check patency of the tube.
2. check placement b4 irrigating 3. instill 30-50ml of water or NS with an irrigation syringe 4. pull back syringe to withdraw fluid to check patency, repeat if tube remains sluggish |
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removal of NG tube
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tell pt to take a deep breath and hold, remove the tube slowly in 3 to 6 seconds. Coil tube around hand as its being removed.
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GI feeding tube types
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NG; nose to stomach
gastrostomy; stomach jejunostomy- jejunum |
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types of GI tube feeding administration
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intermittent(bolus)-resembles normal feeding pattern. 300-400 ml of formula is administrated over 30 to 60 minutes q 3-6 hours.
2. Continuous-adm. continuously over 24 hours, infusion pump regulates flow. 3. cyclical- adm. either day or night for 8-16 hours, infusion pump regulates flow. |
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positioning of GI patients
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hob elevated 30 degrees at all times
comatose- right side |
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GI feeding precautions
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Do not allow food to hang for more than 4 hours (bacterial growth)
check exp. date b4 administering shake formula well b4 administering |
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intestinal tube-description and type
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pass nasally into the small intestine.
used to decompress the bowel and remove intestinal contents CANTOR/HARRIS TUBE-single lumen MILLER ABBOTT tube- double lumen |
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instestinal tubes intervention
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1. position client on right side
2. xray determines placement 3. check the abd. measure the girth 4. if tube is blocked notify rn OR dr. small amount of air to be inject might be prescribed |
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esophageal and gastric tubes- description
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used to apply pressure against esophageal veins to control bleeding.
(not used w pts that have ulcerations or necrosis of the esophagus, or had previous esophageal surgery |
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Sengstaken Blakemore tube
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triple lume tube with an inflatable esophageal balloon, an inflatable gastric balloon,and a gastric aspiration balloon.
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Sengstaken Blakemore tube- interventions
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Client is placed in high fowlers for tube insertion.
Monitor for resp distress , if occurs notify RN, tubes will be cut to deflate balloons. Monitor for esophageal rupture(drop in bp, back and upper abd. pain) its an emergency must be reported immediately. |
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urinary catheter care
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1.use gloves, wash the perineal area w warm water
2. with the nodominant hand pull back the labiaor foreskin to expose the meatus. 2. Clean along the catheter w soap and water 3. anchor catheter to thigh 4. maintain the catheter bag BELOW the level of the bladder |
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__ tube can cause __ and __ __ damage.
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Endotracheal
mucosal, vocal cord |
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whats the reason for endotracheal tube (ET tube)
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used to maintain a patent airway.
indicated when pts need mechanical ventilation |
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orotracheal tube- description
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inserted through the mouth.
indicated when the client has a nasal obstruction or a predisposition to epistaxis uncomfortable and can be manipulated by the tongue |
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nasotracheal tube-description
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requires the use of a smaller sized tube.
discouraged for clients w bleeding disorders |
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extubation
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1.hyperoxygenate the client, suction the endotracheal tube and oral cavity
2. semi fowlers position 3. cuff is deflated, have pt inhale, at peak inspiration the tube is removed and airway is suctioned through the tube as it is pulled out. 4. cough and deep breathe |
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chest tube draining system- description
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returns neg pressure to intraplural space
used to remove abnormal accumulation of air and fluid from the the pleural space |
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water seal chamber
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tip of the tube is underwater, thus allowing fluid and air to drain from the pleural space and preventing air from entering
water oscillates(moves up as pt inhales move down as the pt exhales *CONTINUOUS bubbling indicates an air leak in the chest tube system* |
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suction control chamber
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provides suction which can be controlled by neg pressure to the chest
gentle bubbling indicates that there is suction |
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collection chamber-interventions
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Monitor drainage- physician is notified if drainage is more than 100ml/hr, or bright red and increase suddenly
mark chest tube drainage in the collection chamber every 1-4hour intervals |
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water seal chamber- intervention
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monitor fluctuation of the fluid level
fluctuation stops if the tube is obstructed continuous bubbling indicates air leak in the system(notify rn and physician |
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If the chest tube is accidentally pulled out of the chest, what should you do?
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Pinch the skin opening together
apply occlusive sterile dressing cover the dressing with overlapping 2inch tape notify the rn and dr. stat |