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NUR 431L Final Exam (lines, tubes, drains) Questions with Correct Answers
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NUR 431L Final Exam (lines, tubes, drains) Questions with Correct Answers
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NUR 431L Final Exam (lines, tubes,drains) Questions with Correct Answers
Hemodynamic monitoring - Answer-____ is the measurement of pressure, flow, and O2
within the CV system
-OUR job as the nurse is to gather the supplies which include pressure bag, NS,
transducer, tubing, dressing, cable to hook up to monitor BP
-NS bag has to be changed q 3 days so make sure to label!
-The pressure bag helps to prevent clots by creating a higher pressure than the
pressure in the body
-Place the transducer at the level of the heart
-You have to zero out the pressure of the transducer before you use it (ex. when we go
to another floor, when it's not working; pt has to sit at 60 degrees)
-The pressure bag must be inflated to 300 mm Hg - Answer-Correct way to monitor pt
with a pressurized hemodynamic monitoring:
-trauma pt
-post arrest
-pt on vasopressors
-R failure, ventilator - Answer-Population with an art line:
ARTERIAL LINES: - Answer--This line sits in an artery; very nice line because it gives
you a constant BP (systolic, diastolic, MAP) monitoring and ABGs so we don't have to
stick for this
-Inserted via arm, groin, brachial artery, foot, radial artery is the best
-Easy access, good blood flow, and least likely to cause complications
-We can take out an arterial line but we can't put it in
-Allen test- before inserting into the radial artery, we do the Allen test which is to confirm
that ulnar circulation to the hand is adequate
-We ALWAYS waste the first few cc for blood draw
-Shorter than central lines; when taken out, apply pressure for at least 5 min - Answer-
ARTERIAL LINES:
-include bleeding (hemorrhage)
-letting air into the hand
-clot
-infection
-NV impairment
-loss of limb - Answer-complications of arterial line
, -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)
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