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73 Cards in this Set
- Front
- Back
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TUBES & LINE
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Saline/Heparin lock- a catheter with short tubing. Used for easy vessel access
Cap should be cleaned with alcohol Flush w/saline before and after (5ml) Do not force saline through needle, clot could be dislodged |
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SWAN-GANZ CATHETERS
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Balloon tipped catheter used to measure heart pressure, and cardiac output
Pulmonary artery catheter |
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CENTRAL VENOUS CATHETERS
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Inserted in the upper chest or neck
Used for: repeated venous access, transfusion, chemotherapy, antibiotic therapy, TPN, blood draws |
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CENTRAL VENOUS CATHETERS
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Chest x-ray taken for placement and to check for pneumothorax
(hickman, triple lumen, groshong, CVP) central venous pressure |
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PICC LINE
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Peripherally inserted central catheter
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PORT-A CATH
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Self-sealing port placed under the skin
pt is injected through the skin into the port TIVAS- totally implantable venous access system |
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NG TUBE
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NAsogastric tube- inserted in nose to the stomach
Dobbhoff |
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PEG TUBE
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percutaneous edoscopic gastrostomy
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ET TUBE
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Endotracheal tube- inserted in the mouth and to the bifurcation of the trachea
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CHEST TUBE
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tube inserted between the ribs and into the pleural space of the lungs
helps to drain air or fluid |
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URINARY CATHETER
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Foley Catheter
always clamp the catheter during exams to visualize the bladder |
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URETERAL STENTS
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inserted from bladder to renal pelvis
Double J |
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PH PROBE
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Used to test for reflux disorder
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PACEMAKER
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Implantable and programmable device to stimulate heart function
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CONTRAST AGENTS
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Used to enhance subject contrast
categorized as drugs because they can be absorbed and may affect a physiologic response |
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TYPES OF CONTRAST MEDIA
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Negative agents and positive agents
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NEGATIVE AGENTS
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*air, CO2 crystals, ovygen
*low atomic numbers, (z Number) *Radiolucent *increases radiographic density |
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POSITIVE AGENTS
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*e.g. barium sulfate and iodinated contrast
*high atomic numbers *decreases radiographic density *radiopaque |
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GROUPS OF POSITIVE CONTRAST AGENTS
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1. Barium sulfate
2. Water-soluble 3. Oil-based contrast |
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BARIUM SULFATE (BASO4)
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*inert inorganic salt
*used exclusively for radiography of the GI tract *least toxic contrast if used in the INTACT GI tract (no perforation< ulcerations) *comes in several forms: dry powder, liquid, paste, pill |
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ADMINISTRATION ROUTES FOR BARIUM
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*oral
*rectal |
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ORAL ADMINISTRATION
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*barium itself has no flavor, has chalky consistency
*most palatable when cold and offered with a drinking straw, which helps prevent it from coating the mouth. |
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RECTAL ADMINISTRATION
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*disposable enema kits are available that include a plastic bag, enema tubing, and a rectal catheter (enema tip)
*liquid barium suspension may be poured into a disposable bag and diluted, it required, with COLD WATER *cold liquid is less likely to cause bowel spasms w/the discomfort of cramping |
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RISKS/ SIDE EFFECTS OF CONTRAST
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additive allergy:
-oral barium preparations containing: coloring flavoring additives -check w/ patients about possible allergies to these substances |
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INSPISSATION
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*process of thickening be dehydration
this problem is also increased by the normal function of the colon , which is to absorb water from the bowel contents. Constipation may lead to impaction* |
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IMPACTION
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*condition of being pressed closely together and firmly fixed
-non-invasive treatments include increased intake of fluids and fiber,and exercise -use of laxatives may be dangerous other treatments include using enemas to soften the impaction and digital manipulation (finger) -Surgery may be necessary if bowel is totally obstructed |
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PARENTERALLY
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*as by intramuscular or intravenous injection
Barium is not water soluble and cannot be given parenterally barium extravasation(leakage) into peritoneal cavity cannot be absorbed and therefore presents a very serious complication |
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EXTRAVASATION
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refers to the leakage of a fluid out of its container
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WATER-SOLUBLE CONTRAST
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-mixes readily with blood an other body fluids
*most intravascular contrast agents contain iodine (iodinated) *can be administered by oral, vaginal, intravenous, and arterial routes *commonly used in examinationsof the GI tract, gallbladder, pancreas, heart, brain,adrenal glands,arteries, veins,and joints |
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IODINE CONCENTRATION
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-determines degree to which the contrast medium will ATTENUATE x-rays
(absorb) |
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ATTENUATE
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- weaken, dilute,thin,reduce,diminish
-decrease in intensity of electromagnetic radiation due to absorption or scatter* |
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HIGHER CONCENTRATION OF IODINE
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= provides more positive radiographic contrast (whiter)
= greater viscosity, greater osmolarity =BUT greater toxicity |
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OSMOLARITY
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-number of particles in solution per kg of water
*is realted and responsible for the ADVERSE effects of the contrast ***Higher osmolarity=higher risk of reactions |
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VISCOSCITY
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-measure of the resistance of fluid to flow
*agents w/high iodine concentrations tend to be more viscous (thicker) *important consideration in determining flow rate, injection time, and needle size at cool temp. iodinated contrast media are very viscous (thick + sticky) Viscosity may be reduced by warming the medium to body temp. before injection |
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TOXICITY OF IONIC MEDIA VS. NON-IONIC MEDIA
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-toxicity of a contrast medium is realted to:
iodine concentration osmolarity ionization characteristics rate of injection total amount administered |
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NON-IONIC CONTRASTS HAVE LOW OSMOLARITY, WITH LOW IODINE CONCENTRATION AND WHEN INJECTED ARE LESS TOXIC AND ARE LESS LIKELY TO RESULT IN ADVERSE REACTIONS
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*special water-soluble iodine compounds(gastrogafin and hypaque sodium oral) are available for contrast examination of the GI tract
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ORALLY OR ENTERALLY
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ENTERAL= into the alimentary canal
tube in the nose=nasogastric tube tube that goes through skin into stomach= gastrostomy tube |
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INTRATHECALLY
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into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord: within the spinal canal
e.g. Myelography- intrathecal injection via lumbar puncture |
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INTRAVENOUS/INTRA-ARTERIALLY
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DIRECT INJECTION INTO ORGANS
-when injected, they circulate in the blood and are excreted by the kidneys ***adverse reactions that occur may range from mild severe and life threatening |
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OIL-BASED CONTRAST
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developed for studies in which absorption of contrast into the surrounding tissues, or mixing of contrast with body fluids, is not desired.
Thiodol Hsg's formerly used for myelography & lymphography |
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RISKS WITH OILS
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-not water soluble and not absorbed well by body
-not readily absorbed and tend to persist in the body for long periods. -NOT for IV injection (causes embolisms) occlusion of a blood vessel by a loose clot, air bubble or other particle |
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GASES
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absorb less radiation and produce negative contrast (dark) on the film.
-carbon dioxide and air most frequently used. -may be used alone or in combination with a positive contrast medium for studies UGI,ACBE, arthrography, myelography (spinal canal) for those allergic to iodinated contrast media |
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IVU
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low residue diet
NPO 8 hrs prior to exam *check BUN (blood urea nitrogen): 8-25 *Check creatine: 0.6-1.2 |
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ORDER OF EXAMS
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1. IVU
2. BE prep and enemas until clear, continue next day 3. ESOPH. 4. UGI 5. SBS |
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FIVE RIGHTS OF MEDICATION ADMINISTRATION
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1. right patient
2. right medication 3. right dose 4. right time 5. right route |
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ENTERAL ROUTES
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ENTERAL= pertaining to the intestines
A. sublingually b. rectal route c. nasogastric tube d. PEG tube e. oral route |
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SUBLINGUALLY
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drugs placed under the tongue or inside the cheek
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RECTAL ROUTE
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for pts. who are severely nauseated or unable to swallow.
-medications can be absorbed directly through rectal mucosa -various forms of suppositories and enemas are available for this purpose |
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NASOGASTRIC TUBE
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-through the nose to the stomach
very effective, and dosage is easily controlled |
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PEG TUBE
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percutaneous edoscopic gastrostomy
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ORAL ROUTE
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easiest and most familiar
tablets, capsules, granules, liquids |
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TABLETS
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enteric or coated tablets
allow medication to pass through the stomach before dissolving these should not be chewed or broken since this would negate the benefit of the enteric coating |
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INHALATION
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vaporized liquid medications administered by an inhaler or nebulizer and inhaled by the pt.
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TOPICAL ROUTE
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application of medication to the surface of the skin or transdermally
Transdermal- medications are applied to the skin and are absorbed through skin into the bloodstream |
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PARENTERAL INJECTIONS
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medications that are injected directly into the body
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INTRADERMAL
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between the layers of the skin
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SUBCUTANEOUS
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Sub Q
under the skin |
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INTRAMUSCULAR
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IM
into the muscle |
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INTRA-ARTERIAL
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into the artery
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INTRATHECAL (INTRASPINAL)
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into the fluid-filled space between the thin tissue that cover the brbain and spinal cord
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INTRAVENOUS
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into the vein
used to administer medications, parenteral nutrition, or chemotherapy, injected contrast media for exams |
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FDA REQUIRES THAT ALL DRUG PACKAGES INCLUDE THE FOLLOWING DATA...
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1. trade/brand name
2. generic name 3.chemical composition & strength 4. usual dose 5. indications (uses) & contraindications (when NOT to use) 6. reported side effects |
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DRUG PACKAGING
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*Ampules
*Vitals |
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AMPULES
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glass containers w/ narrow necks
opened by breaking the glass |
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NEEDLES
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gauge= diameter of the hole
Gauge increases as diameter of hole decreses. an 18 gauge needle is larger than a 22 gauge needle |
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VENIPUNCTURES
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accomplished w/
a hypodermic needle a buterfly set, an IV catheter (angiocath) |
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BUTTERFLY SET
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preferable to a conventional hypodermic needle for most IV injections w/ a syringe
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IV CATHETERS
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for repeated or continuous Intravenous injections or infusions
2 part system consisting of a needle that fits inside a flexible plastic catheter |
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OVER THE NEEDLE IV CATHETERS
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-commonly used
-can be left in place for extended times |
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CATHETERS
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diameter measured in FRENCH
-small number= small lumen foley catheter, NG tube |
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EXTRAVASATION (INTRAVENOUS)
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injection of fluid into surrounding tissue
-symptoms are swelling, redness, tenderness -skin is cool at injection site -during injection, pull back on syringe and ensure blood return -pull needle, elevate body part, apply warm compress |
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INJECTION PUMPS
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-used to administer a precise dose
-prevents overdose when narcotic drugs are used -allows for accurate feeding via NG or PEG tubes - can be used for Total Parenteral Nutrition (TPN) |
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IV BAGS
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IV bags should hang at least 18 inches above injection site
-donot allow line to kink -ensure long lines are not under wheelchair or stretcher wheels |
