NRSG 302 NG Tubes/Drain Care Questions & Answers Solved 100% Correct!!

Close [active] system? Example? - uses vacuum system to withdraw fluid and collect in reservoir, a perforated silastic tube is placed in the surgical opening during the surgical procedure i.e. Jackson Pratt Drain 100ml, Hemovac Drain 500ml Dishiscence - the splitting open of a wound Documentation for Penrose shortening include? - Wound assessment Characteristics of drainage on old dressing Wound care provided Shortening length of penrose drain Type of dressing applied Documentation jp/hemovac removal include? - Wound assessment Characteristics of drainage on old dressing Wound care provided Characteristics of drainage from active drain Type of dressing applied Evisceration - extrusion of organs outside of cavity through an open would, blood supply to organs is compromised How do remove an NG tube? (8) - 1. check order for removal 2. apply blue pad to patient chest, remove tape and unpin gown 3. may instil 50 ml of air into the NG tube to prevent aspiration 4. instruct patient to take deep breath and hold (closes glottis) 5. remove in smooth motion 6. inspect to ensure tip intact7. provide oral and nasal care 8. document How do you measure the length of an NG for palcement? - measure from the tip of your ear, to the mouth, to xiphoid + 2 inches JP & Hemovac Emptying? (8) - Gradually reduce the charge [pressure] of the drain, face away Empty contents into a specimen container Maintain sterility of port Cleanse port with alcohol Re-charge and close port Secure device to gown with safety pin hanging below wound Note characteristics - amount, color, consistency, odor Document procedure JP & Hemovac Removal? (13) - Requires physician order to be removed, may be for post op timing or amount of drainage [i.e. POD2, or when <30ml/24hr] Empty drain and leave uncharged Cleanse wound first, then drain site starting at insertion site and working away Remove suture if in place Stabilize skin over drain insertion site with 4x4 gauze Have the patient take a deep breath and slowly exhale Smoothly remove drain with exhale in a steady motion Apply pressure over drain site for 2 minutes Observe that end of drain is intact Cleanse drain site when removing 4x4 gauze Cover with sterile dressing Assess site dressing 30 minutes after removal for dressing dry and intact or shadowing Document procedureLeave post op drsg intact for hoe long? - 24-48hrs unless otherwise ordered Levin Tubes - used for feeding and have a smaller bore, single lumen, more flexible, softer and less irritating more than 200 ml in 4 hr gastric residual volume may be indication of? - patient is not tolerating the rate of feeding Nasogastric Tube (NG tube) - a flexible plastic tube inserted through the nostrils down the nasopharynx, and into the stomach or the upper portion of the small intestine Open [passive] system? exmaple? - uses a soft, flexible rubber tube to maintain an opening in tissue to prevent a build up of fluid, the fluid makes it way out of the tissues and is deposited onto a sterile covering dressing, it may be sutured in place to prevent accidental removal i.e. Penrose Drain Penrose Shortening? (8) - Shortening amount and timeline will be ordered by the physician This would be done with a routine sterile dressing change Set up sterile field with added sterile scissors, safety pin and suture blade After cleansing of site, remove suture [first time] Pull penrose out of tissue as per shortening order Insert sterile safety pin at new length and cut 2 cm above new pin site Apply Y dressing around tube site, secure covering dressing Document procedure