I've bee a PCT on an abd tx unit for 2 months now. I figured drains should be emptied as often as possible/reasonable. Some RNs harass me to empty their pts drains when I am doing other things and it's not more than half full or near end of shift, while one told me something different. There is a pt on our unit with an abdominal jumbo JP that fills up less than an hour after you empty it. An RN told me only empty it Q4H to prevent the pt from losing too much albumin. I think the pt was already running low. However, no other RN has found this important even when I tell them what the other RN said. I'm wondering if this is situation specific or if there is a rule of thumb. I'll be asking my unit director, but I was hoping to get more opinions on the subject. This pt also has Alzheimer's and tends to run hyponatremic with confusion varying from mild to severe and aggressive/ anxious. I mention this because he has opened and spilled his JP a few times. Once when he was NPO and I was in the room and asked why he was trying to open it, he told me he thought it was a drink.
Any insight would be appreciated, as drains are something I've been struggling with. I've seen:
hemovac (always seen draining blood from site in orthopedic pts, why aren't JPs and hemovacs interchangeable?)
foley (recently saw foley-bag-bag with bladder irrigation... had to empty it every 30m-2h depending on the flow rate)
peg-tube (what is that draining?)
NG tube-feed or suction (those kind of scare me- I drained one and forgot to turn suction back on when I was done emptying until about 5 min later)
ostomy, fistula ostomy? (didn't assess her abdomen to check, but researched this and believe it is still an ostomy.. pt had tubing running down her pants leg and collection bad was tied to her ankle... when she was NPO it smelled like vomit, whereas when she was eating the odor was like any other ostomy... not sure if there's a connection.)
As far as I can tell, drains can go anywhere there is excess fluid or no other way to release fluid, and what drain/bag the surgeon/RN places is their call, although the amount of fluid putting out narrows it down. I guess my main question with drains is usually, what is that draining and when do you know your pt needs drainage? For example, I've seen distended abdomens where one pt had an NG-tube-suction putting out thicker, slightly chunky green fluid while one had a jumbo JP putting out yellow-orange fluid with occasional clots. Also, with so many bag types and sizes, how do you decide which to use if it is your choice as an RN and your facility carries different types? Is it just personal preference, MD orders, etc.?
Sorry, I'm not sure if this is a dumb thing to be stuck on but I'm a stickler for details. I failed an exam in OB lecture bc I got so caught up on how/why the menstrual cycle lines up with the hormonal cycle and the luteal cycle, I didn't study anything else!
Also please correct me if any terms I've used aren't nursing appropriate, as that is something else I'm struggling with in clinical. Thanks!