NCLEX-CGFNS: Care With Tubes

There is a specific care for patient with specific tube. Some real questions of NCLEX-CGFNS exams were found asking the principles in providing nursing care to patients with tubes.

Let's review most commonly tube that questioned on NCLEX-CGFNS exam.

BROVIAC CATHETER
It a single lumen usually used for patient with small central vessel (children and elderly).

CANTOR TUBE

• It is used for intestinal drainage.
• The balloon is injected with 4-5 ml of mercury before insertion of the tube.

CHEST TUBE

• It is used to allow air and fluid drain from the pleural space.
• Fluid fluctuation in the water seal chamber will stop when the lungs has reexpanded.
• Sterile water should be used in the water seal chamber.
• Keep two hemostats at bedside to clamp chest tube if the system becomes disconnected or broken.

GROSHONG CATHETER

• It is a double lumen catheter used for long term central venous access and infusion fluid (antibiotics, total parenteral nutrition, blood or chemotherapy)
• The catheter should be checked periodically for kinks and leakage.
• Saline solution can be used for flushing to clear the full length of catheter.

HEMOVAC

• It is used to maintain constant drainage from wound and to prevent pressure on skin flaps.
• The tubing is milked away from the patient every 1-2 hours for the first 24 hours posoperatively and then 4 hours and as needed.

HICKMAN CATHETER
It is triple lumen as same purpose as Groshong catheter.

JACKSON-PRATT DRAIN

• It is used for wound drainage.
• The negative suction should be maintained by compressing the reservoir before attaching it to the tubing.

LEVINE TUBE

• It is a single lumen used to remove air and fluid from stomach.
• Frequent irrigation is required.

MILLER-ABOTT TUBE

• It is a double lumen tube used for intestinal drainage and irrigation.
• One lumen is connected to the balloon and filled with mercury after insertion, other lumen is opened for drainage and irrigation.

SALEM-SUMP TUBE

• It a double lumen tube used for suctioning gastric contents.
• One lumen is used for air entry that keeps the gastric lining from occluding the drainage hole.
• Frequent irrigation is required.

SENGSTAKEN-BLAKEMORE TUBE

• It used to stop bleeding from esophageal varicose by applying pressure.
• The esophageal balloon can be left inflated for up to 48 hours without tissue damage.
• Keep a pair of scissors at bedside.

THREE-WAY FOLEY CATHETER

• It is used to drain bladder.
• Keep strict asepsis when inserting and assembling the drainage equipment.
• It is changed when obstructed by sediments.