What is the proper location for a Chest Tube? - ️️fourth to fifth intercostal space in
the anterior or mid axillary line at the horizontal level of the nipple; once this is felt, move
hand laterally toward anterior axillary line which is the area of incision, the insertion site
is one interc...
AHN 568 Advanced Procedure videos
Exam 5
What is the proper location for a Chest Tube? - ✔️✔️fourth to fifth intercostal space in
the anterior or mid axillary line at the horizontal level of the nipple; once this is felt, move
hand laterally toward anterior axillary line which is the area of incision, the insertion site
is one intercostal space above incision site
what are some complications of a chest tube? - ✔️✔️bleeding and hemothorax,
perforation of visceral organs, perforation major vascular structures, intercostal
neuralgia due to trauma of neurovascular bundles, SQ emphysema, reexpansion
pulmonary edema, infection of drainage site, pneumonia, and empyema; could also see
technical problems such as tube blockage or incorrect positioning
To administer anesthesia after a lumbar puncture, what two drugs could be used? -
✔️✔️narcotics, bupivocaine
if a patient has ventriculitis or meningitis, what could be a therapeutic indication for a
lumbar puncture? - ✔️✔️antibiotic administration of vancomycin, gentamycin
if a patient has leukemia or lymphoma, what would a therapeutic indication for lumbar
puncture be? - ✔️✔️administration of methotrexate or chemotherapy
what type of patients should avoid lumbar punctures? - ✔️✔️patients who are
cardirespiratory compromised, patients with cerebral herniation/increased ICP and focal
neurologic signs, coagulopathy increases risk of hematoma
what size needle should be used for a lumbar puncture and why? - ✔️✔️22-gauge,
3.5in (8.9cm) because smaller hole decreases risk of CSF leakage
what position should patient assume for lumbar puncture? - ✔️✔️lateral recumbent is
preferred but sitting is also acceptable
why is the lateral recumbent position preferred? - ✔️✔️to reduce risk of post-puncture
headache and to obtain an accurate opening pressure
once patient is in correct position, what should you instruct the patient to do? - ✔️✔️to
adopt the fetal position or arch back like a cat to widen the gap between spinous
processes
where should a needle be inserted for lumbar puncture? - ✔️✔️between L3--L4, or L4-
L5 because these points are below termination of spinal cord
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