Got tubes
This tube is inserted through the mouth using endoscope and a small incision is made through the exterior of the stomach where the tube is passed through the hole and to the outside of the body.
What is a PEG tube
This is how often oral care should be performed when a patient has an NG tube
What is q2h?
These are some of the effects of nicotine on the body
Kills cilia in respiratory tract, is a chemical irritant that causes cancer, vasoconstrictor of blood vessels and leads to HTN.
These are the early signs of hypoxemia
Reslessness, irritability and tachycardia
How often should the Toomey syringe be changed for bolus feedings?
q24 h
The purpose of this tube is to :
Administer nutrition directly to GIT (supplemental, total/ cyclical or continuous)
Administer medications
Decompress GI tract
Short term nutritional support (less than 4 weeks)
What is an NG tube
This is the reason a bridle retaining device can't be used on a patient
When a patient is confused
These are the levels of a normal ABG
pH 7.35-7.45
pC02 35-45 mmHg
Pa02 80-100 mmHg
Sa02 95-100% mmHg
Bicarb 22-26 mEq/L
Major classes of brochodilators
Beta 2 -andrenergic-agonist agents (mimick sympathetic response) -albuterol, (the ol's)
Anticholinergic agents (blocks acetylcholine, parasympathetic response) the ium's (ipratropium bromide (arovent, ipraxa)
Both classes have Short and Long acting varieties
this is the amount of the gastric residual that is acceptable and returned to patient and what is not acceptable.
Return GRV of less than 250ml to patient if greater than 250ml check policy before returning. Hold feeding if greater than 500 ml once or 2 separate GRV of greater than 250ml one hour apart.
Tube that is smaller and softer and less irritating, Inserted through nose, but kinks and plugs easily, difficult to aspirate residual and is not placed by nurse at bedside: placed in IR by provider
What is either a ND or NJ tube?
When should you flush/irrigate an enteral tube
Before/after medication administration (30-60 ml H20)
Between each medication added one at a time (5-10 ml H20)
Before and after intermittent or bolus feedings 30-60 H20
Every 4 hours for continuous feedings 30-60 H20
Every 4-8 hours irrigate a NG decompression tube for patency with NS
These are the s/s of acute bronchitis
What is paroxysmal cough, severe coughing (first productive then non productive) chest wall pain, fever and malaise, adventitious LS (wheezing and scattered rhonchi)
Two types of pleural effusion
Transudative (fluid leaking into pleural space from increased blood vessel pressure or low protein count) HF is most common cause
Exudative (blocked blood vessels or lymph vessels, inflammation, infection, injury or tumors)
Sp02 vs Sa02 (compare and contrast)
Sp02 measures o2 sat of functional hemoglobin.... Sa02 is both functional and non-functional
Sp02 is by pulse oximeter
Sa02 is by blood gas
Sp02 is percentage of hgb in peripheral blood saturated with oxygen
Sa02 is percentage in arterial blood
This tube has a large lumen to decrease plugging and is placed by nurse at the bedside. One major disadvantage is that it can cause aspiration is rigid and can become dislodged easy.
What is an NG tube?
Pt feels fullness, cramping, nausea, dizziness, is diaphoretic and has a rapid heart rate with low blood pressure during a tube feeding.
What is s/s dumping syndrome
These are the risk factors for pneumonia
advanced age, immunosuppression, decreased or altered LOC, upper URI, immobility, difficulty swallowing. Smokers, and hospitalized patients on opioid therapy.
Important considerations after thoracentesis:
The dressing needs to be occlusive (water and air tight)
Assess for pneumothorax
don't have pt lay on affected side
if dressing is saturated with blood/fluid(notify HCP immediately)
symptoms of asthma include:
Chest tighness
wheezing
dyspnea
cough
(if worsening, pt uses accessory muscles)
This tube is for long-term nutritional support greater than 4 weeks, is inserted through the stomach, usually permanent and is placed during general anesthesia
What is a G-tube Gastrostomy tube
These are the Complications of receiving enteral tube feedings along with the 2 most common *
*What is aspiration pneumonia, *clogged tube/displacement, nasal erosion, Refeeding syndrome, diarrhea/constipation, N/V, dehydration azotemia (increased BUN and Creatinine), possible dumping syndrome
pharmacotherapy for pneumonia
bronchodialators (proventil, astrovent)
mucolytics
cough expectorant (day) suppressant (night)
antipyretics (fever) and supplemental 02
antibiotics (prescribed)
A C&S is for________ and the specimen needed is a ________
A culture and sensitivity test cultures the bacteria to find a pathogen and tests which antibiotics are effective. First-morning sputum is best. Make sure it's from a deep cough.
The medication that is the mirror image of Albuterol but does not cause elevations in heart rate. This medication is very expensive and is mostly used by pt with arrhythmias who also have asthma.
Levalbuterol