Nursing Technology

amprevel's version from 2016-04-05 05:38

IV Catheters

Question Answer
How do central line access and peripheral access differ?Nurses insert peripheral (limbs) IVs and physicians insert central (neck/trunk) catheters per their scopes of practice
What is a benefit of central line placement?During immediate need for venous access, the jugular and subclavian veins are easy to find, access, and to put in a large gauge needle (allows for faster delivery), shorter distance for corrosive meds (chemo) to travel
What is a Groshong tip?A 3 way valve end that opens with either negative or positive pressure, when no pressure is applied it remains closed. Decreased risk of clot, does not need to be flushed.
How is a Groshong catheter inserted?Surgically inserted central line with a 3 way valve tip, that is usually tunneled under the skin. Placement is verified by fluoroscopy. Can be used for long-term IV treatment.
What is a central line multi-lumen catheter?Central catheter with 3 (sometimes more) lumens , short term use to monitor central venous pressure, sample blood, and administer meds/fluids.
What is a Swan-Ganz catheter and what is it used for?A flow-directed balloon-tipped pulmonary artery catheter (also called a PAC), feed through the right atria and ventricle to sit in the pulmonary artery, monitors heart function and blood flow.
What is a hep-lock?Now referred to as an IV lock, allows for intermittent IV access. Saline is most commonly used to flush the line (previously heparin was used = "hep-lock")

Needles & Syringes

Question Answer
How large is a TB syringe and what can it be used for?1 cc (measured in tenths and hundredths), small doses, pediatric patients. MAY NOT BE USED WITH INSULIN
What sizes do insulin syringes come in and how are they measured?30, 50, 100 Units. Use smallest syringe that will allow dosing (e.g. 4 unit dose in a 30 unit needle). ONLY USE WITH INSULIN
What is a Luer-Lok tip?Screw tip on syringe, IV, catheter to attach needle, IV set, etc (Benefit: Needle can’t stay in arm when pulling out after injection)
What is a filter needle and when is it used?The hub contains a filter disc to filter out glass/particles to protect patient from possible injection of foreign bodies. Used to draw up meds from glass ampules or with particles from reconstitution
What does the gauge of the needles represent?The diameter of the shaft. The larger the number, the smaller the needle.
Most common gauge needle used for sub-q injection?25 Gauge for subcutaneous
Most common gauge needle used for IM injection?21 Gauge for intramuscular
What length of needles are most often used for IM injection?1 - 1.5” most common for IM, must be long enough to reach the muscle at a 90 degree angle
What length of needles are most often used for sub-q injection?5/8” most common for sub-q, administered at a 45 degree angle
What is the benefit of needle-less cannulas?Prevents needle-sticks, and is compatible with ports on IV sets (Y ports) and injection sites on bags and IV locks.

Drains & Chest tubes

Question Answer
What is the benefit of using a Hemavac drain?It is a closed-wound drainage system = PROMOTES HEALING TIME, prevents microorganisms from entering the line.
How does a Hemavac drain work?Inserted in/near surgical wound site via tube, the blood and fluids are drained into a spring loaded, gravity-fed reservoir. Squish down on device to create vacuum (careful- too much suction pressure = tissue damage)
What is a Jackson-Pratt drain?Closed-wound drainage system with a bulb at the end - Bulb is squeezed flat to create suction to pull fluid from wound (bulb shown in class can hold up to 100 cc of fluid)
What is the main function of a chest tube?Drain air, fluid, and/or blood in the pleural space to restore the negative pressure in the lungs. Because air rises, chest tubes for pneumothorax are placed in the upper anterior thorax, to drain blood and fluid generally are placed in the lower later chest wall
What danger is associated with manipulation or clamping of a chest tube?Tension pneumothorax
How does the chest tube water system work?When client inhales the water prevents air from entered the system, during exhalation air exits and bubbles up through the water. Comprised of suction control chamber, water-seal chamber, and closed collection chamber for drainage
What is a Heimlich chest valve?A waterless system that is comprised of a one way flutter valve, primarily used to treat pnuemothorax. Small so patients can be mobile. Blue, proximal end to patient’s chest tube, distal end to the environment for air, or to a collection bag if draining fluids. Inserted in the improper direction can cause tension pneumothorax
What is an ostomy bag?a 1 or 2 piece appliance used to collect fecal waste from a stoma. It is important to asses skin when appliance is changed (esp for ileostomy, which contains digestive enzymes)
What is the nurses role in regards to chest tubes, drains, ostomies?Nurses are responsible for care/management/pt education.

Parenteral Medication and Safety

Question Answer
What is an ampule?A sterile glass container containing a single dose of medication. Because neck of vial must be broken to open, dispose of in sharps container, use a filter needle to withdraw med.
What is a vial?a container with a rubber stopper that must be punctured with a needle to withdraw med. Can be multi or single dose. CDC prefers single dose. Because vial contains a vacuum air must be injected into vial prior to drawing up dose.
What is a Tubex or Carpuject syringe?Devices that hold single dose cartridges of medication. Both are reusable and do not need to be sterilized between use.
What OSHA regulation is meant to prevent needle sticks?Needle-stick safety and prevention act 2001, designed to help protect the spread of blood-borne pathogens. Engineering controls are the primary means of eliminating or minimizing employee exposure and include the use of safer medical devices, such as needleless devices, shielded needle devices, and plastic capillary tubes
Needle disposal container guideline?"Sharps containers" Never overfill, must be properly labeled to warn of contents. Must be FDA approved, made from leak-proof/puncture-proof plastic (a sharp is anything that can cut or stick the skin)
Select all that apply:
a) Most common needle length for IM=5/8"
b) Most common needle length for SQ=1-1.5"
c) SQ administered at 45 degree angle
d) IM administered at 90 degree angle
e) All of the above
Most common gauge for SQ 25G
Most common gauge for IM 21G
For needle gauge sizes, what is relationship of gauge to diameter of shaft?The larger the number, the smaller the needle


Question Answer
Filter needles are commonly used forto draw up meds from glass ampules or with particles from reconstitution
Incentive spirometer is commonly used on limited mobility patients for what?-prevent atelectasis/pneumonia (often post-surgery to counteract effects of anesthesia).
-Gives incentive for inhalation.
-Nurse teaches use.
Sequential Compression Devices (SCD’s)-helps prevent thrombosis or edema by promoting venous return to the heart
-Pts will feel compression from the bottom up
-Pts will have them taken off during bathing, toileting or ambulating
-Stay on continuously/ most of the time
Oxygen flow-meter use and settings-Indicates gas flow in liters per minute
-Required for wall-outlet systems
-Placement of silver ball indicates flow (either above or mid-ball depending on brand)
-Turn knob to adjust ball placement
Pulse oximeterMeasures oxygen sat of hemoglobin (Sp02)/pulse (w/ laser light)
Disadvantage of pulse oxproblems w/accuracy- nail polish, some ethnicities, anemic pts, shock, hypothermia
Suction machine – intermittent or continuous-Frequency of suctioning depends on client’s health and how recently intubation was done;
-Done to facilitate ventilation, remove secretions that may obstruct airway, prevent infection from accumulated secretions
T/F: Sterile technique is recommended for all suctioning.T. Even though upper airways are not sterile, sterile technique is recommended for all suctioning
Complications of suctioninghypoxemia, trauma to airway, nosocomial infection, cardiac dysrhythmia (related to hypoxemia)
Suction catheter - Yankhauer - shape of tip?Catheter with SPECIAL KNOB ON TIP
Where is Yankhauer Suction catheter used?Used in oropharyngeal cavity for withdrawal of fluid (tracheostomy site)


Question Answer
What are the calibrations on a 3cc syringetenths of milliliters
3cc syringe commonly used for?hypodermic injections
TB or 1 mL syringe commonly used for?doses under 1cc, pediatrics
T/F: A 1 mL syringe (TB syringe) can be used to administer insulin.F. Cannot be used with insulin
insulin syringesare calibrated in units & may ONLY be used to administer insulin
Best syringe to administer a 6 unit dose of insulin if you have 30, 50 and 100 unit syringes?30. Use smallest syringe to allow dosing.
Luer-Lok is what kind of tipscrew tip on syringe
Luer-Lok syringes can attach syringes toneedles, catheters, IV sets; don't screw on too tight or too loose
One benefit of a Luer-Lok syringeNeedle can’t stay in arm when pulling out after injection


Question Answer
A 50mL Catheter tip syringe might be used to:
a) irrigate wounds or tubes,
b) add medications to IV solutions
c) administer oral medication
d) administer medication IM
e) all of the above
A & B
Doppler ultrasound may be used to monitor:
a) pulse (radial, carotid)
b) fetal heart tones
c) arteries, such as carotid
d) all of the above
PCA pump – describe & used for-Patient-controlled analgesia
-Can only be administered by the patient (has lockout setting to prevent overdose)
-Mainly acute care.
Nursing role when PCA pumps are used-monitor vital signs,
-assure patient knows how to use the device,
-educate pt that they are unable to OD/has lockout
Epidural pump-describe & use-Used for pain management,
-only placed by anesthesiologists or nurse anesthetists (usually in lumbar region – L3/L4),
-3 Modes of administration: bolus, continuous infusion, continuous plus intermittent bolus
How would tubing be routed and marked if it is an epidural line?-tubing generally comes up over shoulder
-should be marked with tape to designate it is epidural
When would an interosseus line be placed?Emergency, if cannot get a line another way, vascular collapse.
Advantages of tunneling a catheter to a distant venipuncture site?may decrease infection due to being further from skin
Who inserts a PICC line and what is it?specially trained nurses; Peripherally inserted central catheter
Considerations to remember in suture and staples removalSutures are cut as close to the skin as possible, suture material that is visiable to the eye is in contact with bacteria and should not be pulled beneath the skin during removal, clean incision before and after removal, apply dressing (if ordered)