Central Lines And Chest Tubes

Front 1

The most common type of line- comest in 3-4 lumen catheters inserted in the neck (internal or external jugular), chest(subclavian) or groin.

Back 1

Multilumen central line

Front 2

On a multilumen central line, what is the blue (middle) port used for?

Back 2

TPN

Front 3

On a multilumen central line, what is the white(proximal) port used for?

Back 3

blood drawing

Front 4

On a multilumen central line, what is the brown (distal)port used for?

Back 4

blood product administration

Front 5

A long term catheter that is placed in the OR or radiology.

Back 5

groshong/hickman

Front 6

what is a groshong/hickman catheter used for?

Back 6

-long term
- fluid replacement therapy
- long term TPN
- chemotherapy
- dialysis

Front 7

You cannot access a __________ catheter except in case of emergency or with special certification.

Back 7

groshong/hickman

Front 8

A long-term catheter inserted into antecubital area and threaded through the cephalic vein and placed in or near the superior vena cava. Inserted at bedsie or in radiology. can stay in for months

Back 8

PICC (peripherally inserted central catheter)

Front 9

These are placed on the chest wall and are accessed with a special needle. Are easily palpated and the needle is placed as if you putting it into a medication vial. Often used in cancer patients.

Back 9

Implanted ports

Front 10

What kind of needle do you use with an implanted port? What angle of insertion?

Back 10

huber-straight with a 90 degree angle

Front 11

What veins can a multilumen central line be placed in?

Back 11

subclavian, jugular, or in the groin

Front 12

what veins can PICC lines be inserted in?

Back 12

cephalic vein and placed in superior vena cava

Front 13

Big IV lines that go in big veins that are often long term.

Back 13

central lines

Front 14

what are central lines used for?

Back 14

- alleviate the need for multiple IV sites
- administering IV fluid, medication, PN, blood products, and collecting blood samples.

Front 15

What is a tunneled central line?

Back 15

inserted in surgery or radiology by an MD. Are threaded through a subQ tunnel in the chest wall and the tip sits in the SVC. Ex: groshong, hickman, implanted ports.

Front 16

What is a non-tunneled central line?

Back 16

large-bore insreted into jugular or subclavian, or in the case of PICC, the antecubital fossa.

Front 17

For dressing a central line, use an _____ dressing, change it every _____ hours STERILLY.

Back 17

occlusive

72

Front 18

If the patient pulls out the central line, what position should they be placed in? Why?

Back 18

- L trendellenberg

- because if air did become sucked into the circulation, it will rise into R atrium and not travel into circulation.

Front 19

Blood accumulation in the pleural space usually caused by open chest procedures, blunt or penetrating trauma- usually both air and blood at the apex and base.

Back 19

hemothorax

Front 20

Air in pleural space- collapsing lung that is not able to expand.

Back 20

pneumothorax

Front 21

Who is more at risk for pneumothorax?

Back 21

- COPD
-smokers
- chest trauma
- central line insertion

Front 22

What is tension pneumothorax?

Back 22

When having a pneumothorax, air increases pressure to a dangerous level.May see tracheal deviation, heart compression (cardiac and respiratory impairment)- IS LIFE- THREATENING

Front 23

An abnormal accumulation of fluid in the pleural space (usually in to the 5th or 6th ICS)

Back 23

pleural efffusion

Front 24

What can cause pleural effusion?

Back 24

heart failure
surgery
malignancy

Front 25

What is the purpose of the chest tube

Back 25

to remove air/fluid from the pleural space so the lungs can re-expand

to drain blood from the mediastinum after open heart surgery to prevent cardiac tamponade

Front 26

What are the 3 basic components of a chest drainage system?

Back 26

-collection chamber
- suction control
- water seal

Front 27

When your patient has a chest tube, how often should you check their respiratory status and their occlusive dressing

Back 27

at least q4h

Front 28

When your patient has a chest tube, what are you checking their tube site for?

Back 28

s/s inflammation, infection, subQ air, and pain

Front 29

What are you checking the chest tube for in assessment of your patient?

Back 29

patency, amt of drainage, color and consistency, check for kinks, secure tubing that is taped

Front 30

How often should the patient with a chest tube cough, deep breathe, and change position?

Back 30

at least q2h to promote drainage of accumulated fluid