NUR 431L (LINES, TUBES, DRAINS)
FINAL EXAM QUESTIONS WITH
CORRECT ANSWERS
-Gives you multiple lumens
-Good for high concentrated things/toxic drugs
-Great, reliable assess site to keep pt alive
-Will give us central venous pressure - Answer-We use a central line instead of a
peripheral IV in some situations d/t:
-once medication reaches blood stream, VERY diluted
-Tunnel caths are used for long-term access
-Heparin is only really used in dialysis and those nurses do it
-Our job is to get everything ready; we don't put them in
-Can't use the line until placement has been verified via CXR - Answer-central lines
*Remember it is a DIRECT line to the heart so always clamp and cover (sterile)
*When drawing blood, waste the first 3 cc d/t the long line and the residual that's left
-scrub hub for 15-30 seconds
-release the clamp, with the blue cap on (it's a one-way valve so prevents air from
getting in)
-flush with NS, medication, end with NS - Answer-When collecting a blood draw and
giving meds with a cental line
-check VS, for consent, and if on blood thinners; check colag factors and electrolytes -
Answer-central lines and arterial lines
A chest tube - Answer--is a clear flexible plastic tube that is inserted through the chest
wall into the pleural space or the mediastinum to drain fluid or air from the pleural space
-Doesn't sit in the actual lungs! The whole purpose of a chest tube is to drain something
-Pneumothorax
-hemothorax
-hemo-pneumothorax
-empyema
-pleural effusion - Answer-indications for chest tube
-Bleeding
-hemothorax
-infection
-trauma to NV bundles
-sub-q emphysema
, -perforation of visceral or intra-abdominal organs (placement is the MOST important!!) -
Answer-complications of chest tube
*Connect to suction IMMEDIATELY, secure the device and tube, monitor VS, address
pain level, sterile dressing is applied (some Dx don't want dressing),
-ensure CXR is ordered to evaluate placement and lung re-inflation
-monitor drainage (greater than 5 mL/kg in 1 hour)
*If hemothorax during procedure
-HR, BP, R will increase, then BP and O2 will go down
*When changing from suction to water seal, turn off suction and remove tubing from the
top of the chest tube system - Answer-post of for chest tube
-Sterile dressing changes
-Q 24 hrs or PRN; set up a sterile field/ tear tape (use saline, 4x4s, drain dressings)
-Remove old dressing with clean gloves and discard, observe site, clean site using
circular motion (x3) while stabilizing tube, apply dressing to site, secure with tape, time,
date, and initial dressing
-Planned removal: secure on 4 sides
-Unplanned removal: secure on 3 sides - Answer-Dressing changes for chest tubes
place the end of the tube in 1 inch of sterile water in a sterile cup immediately - Answer-
If the chest tube becomes accidentally disconnected from the pleur-evac or it becomes
damaged
-hemorrhage
-infection
-thrombus formation
-neurovascular impairment, and loss of limb. - Answer-complications of arterial line
(1) pressure bag is inflated to 300 mm Hg,
(2) flush bag contains fluid
(3) system is delivering a continuous slow (approximately 3 mL/hr) flush; because of the
risk of heparin-induced thrombocytopenia (HIT) (use normal saline for the flush solution)
- Answer-To maintain arterial line patency and limit thrombus formation, assess the
flush system every 1 to 4 hours to determine that the:
•Flush tubing & make sure all stopcocks in right place & your clamp is open
•Blow up pressure bag (about 250-300- green line will tell you when)
•Hang transducer tubing, make sure tubing going towards pt. is facing upward and cable
is facing downwards
•Push it, allow air to get out (Flush A line)
•Connect transducer cable to transducer - Answer-Arterial line setup:
-acute hypertension and hypotension
FINAL EXAM QUESTIONS WITH
CORRECT ANSWERS
-Gives you multiple lumens
-Good for high concentrated things/toxic drugs
-Great, reliable assess site to keep pt alive
-Will give us central venous pressure - Answer-We use a central line instead of a
peripheral IV in some situations d/t:
-once medication reaches blood stream, VERY diluted
-Tunnel caths are used for long-term access
-Heparin is only really used in dialysis and those nurses do it
-Our job is to get everything ready; we don't put them in
-Can't use the line until placement has been verified via CXR - Answer-central lines
*Remember it is a DIRECT line to the heart so always clamp and cover (sterile)
*When drawing blood, waste the first 3 cc d/t the long line and the residual that's left
-scrub hub for 15-30 seconds
-release the clamp, with the blue cap on (it's a one-way valve so prevents air from
getting in)
-flush with NS, medication, end with NS - Answer-When collecting a blood draw and
giving meds with a cental line
-check VS, for consent, and if on blood thinners; check colag factors and electrolytes -
Answer-central lines and arterial lines
A chest tube - Answer--is a clear flexible plastic tube that is inserted through the chest
wall into the pleural space or the mediastinum to drain fluid or air from the pleural space
-Doesn't sit in the actual lungs! The whole purpose of a chest tube is to drain something
-Pneumothorax
-hemothorax
-hemo-pneumothorax
-empyema
-pleural effusion - Answer-indications for chest tube
-Bleeding
-hemothorax
-infection
-trauma to NV bundles
-sub-q emphysema
, -perforation of visceral or intra-abdominal organs (placement is the MOST important!!) -
Answer-complications of chest tube
*Connect to suction IMMEDIATELY, secure the device and tube, monitor VS, address
pain level, sterile dressing is applied (some Dx don't want dressing),
-ensure CXR is ordered to evaluate placement and lung re-inflation
-monitor drainage (greater than 5 mL/kg in 1 hour)
*If hemothorax during procedure
-HR, BP, R will increase, then BP and O2 will go down
*When changing from suction to water seal, turn off suction and remove tubing from the
top of the chest tube system - Answer-post of for chest tube
-Sterile dressing changes
-Q 24 hrs or PRN; set up a sterile field/ tear tape (use saline, 4x4s, drain dressings)
-Remove old dressing with clean gloves and discard, observe site, clean site using
circular motion (x3) while stabilizing tube, apply dressing to site, secure with tape, time,
date, and initial dressing
-Planned removal: secure on 4 sides
-Unplanned removal: secure on 3 sides - Answer-Dressing changes for chest tubes
place the end of the tube in 1 inch of sterile water in a sterile cup immediately - Answer-
If the chest tube becomes accidentally disconnected from the pleur-evac or it becomes
damaged
-hemorrhage
-infection
-thrombus formation
-neurovascular impairment, and loss of limb. - Answer-complications of arterial line
(1) pressure bag is inflated to 300 mm Hg,
(2) flush bag contains fluid
(3) system is delivering a continuous slow (approximately 3 mL/hr) flush; because of the
risk of heparin-induced thrombocytopenia (HIT) (use normal saline for the flush solution)
- Answer-To maintain arterial line patency and limit thrombus formation, assess the
flush system every 1 to 4 hours to determine that the:
•Flush tubing & make sure all stopcocks in right place & your clamp is open
•Blow up pressure bag (about 250-300- green line will tell you when)
•Hang transducer tubing, make sure tubing going towards pt. is facing upward and cable
is facing downwards
•Push it, allow air to get out (Flush A line)
•Connect transducer cable to transducer - Answer-Arterial line setup:
-acute hypertension and hypotension
