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NCLEX Cardiac

Subjects : nclex, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is the treatment for a pt. with ventricular tachycardia?
Ask patient to make a tight fist - using your index and middle fingers compress both the radial and ulnar arteries to obstruct blood flow to hand - ask pt to relax hand (hand and palm should appear blanched bc flow stopped) - release pressure on ulna
Awake and alert: IV lidocaine bolus and drip Unconscious - hypotensive - or S&S of angina/CHF: Direct current cardioversion and IV Lidocaine bolus and drip.
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
Open up blood vessels

2. When should you be concerned about premature ventricular contraction?
Stroke - renal or heart failure - paraplegia secondary to compromised blood flow - or death from aortic rupture.
BIRTH CONTROL PILL (LEADING CAUSE of HTN In YOUNG WOMEN-45=STILL YOUNG) - BLACK Male (then white male - than black female - then white female) - obesity - smoking - stress - high Na diet - lack of exercise - age - sex - race - or noncompliance.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).

3. What is the treatment for myocardial infarction?
ST segment elevation (STEMI)
MONA=Magnesium sulfate - O2 - Nitroglycerin - Aspirin (mona has a heart so EKG also if select all that apply).
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea
When they occur >6 per minute or occurring 2 or more in a row (bigeminy or trigeminy=on way out).

4. What should you teach your patient about a holter monitor?

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5. What is the most common cause of arterial insufficiency?
D/C the med and call the doctor.
In fatty areas or over major muscles - large breasts - or bony prominences.
Chronic arteriosclerotic disease.
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.

6. What type of EKG change indicates MI?
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
ST segment elevation (STEMI)
(1ST) BEGIN CARDIOPULMONARY RESUSCITATION (The PT. Is DYING) And NotIFY PHYSICIAN (2ND).

7. What are the four types of pulmonary emboli?
Used in an emergency (Vfib/defib) - used with Vfib or Vtach - NO CARDIAC OUTPUT - client is unconscious - EKG monitor - NO CONSENT NEEDED - begin with 200 Joules and up to 360.
It usually occurs when your heart is working harder (ex: exercising - eating large meal - or feeling stress. Also very hot or cold weather).
Pericardial friction rub: A high pitched squeaking or grating sound during cardiac contraction. It is typically best heard when the patient sits - leans forward - and breaths out.
Fat - Air - DVT - or Amniotic

8. Where should you place your stethescope to find the pulmonic valve?
One large emboli (smaller=better)
Second Left intercostal space
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
When: using anticoagulants - liver disease - decrease in platelets (less than 150 -000) - hemophilia - using thrombolytic meds - DIC - CA - HIV - chemo - bone marrow problems - and ASA/NSAIDS.

9. What are the two common complications of pericarditis?
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
To inhibit thrombus and clot formation.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).

10. What disease can cause right sided heart failure?
Decreased tissue perfusion. Tx: clot busting treatment must start within 6 hours.
The symptoms improve when the patient is sitting in upright position that promotes drainage but worsen with the client is lying down.
Left sternal border
Lung disease

11. Where should you place your stethescope to find the ERB's Point?
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.
Maintain BED REST
(S1 - S2) Third left intercostal space
RAndI= Razor - electric - Aspirin - NO - Needles - small gauge - Decrease - needle sticks - and Injury- protect from. No percodan or NSAIDS - no open toed shoes.

12. What is characteristic of ventricular fibrillation?
Chest pain or discomfort that occurs when your heart doesn't get enough blood and oxygen. Stable: the feeling comes and goes at expected times. Unstable: the pattern of your pain has changed (longer - hurts more - etc.)
Totally disorganized - chaotic pattern - and no discernible waves or complexes.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.

13. What type of surgery is done for an aortic dissection?
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
No radial artery punctures if negative
The damaged portion of the aorta is removed and is repaired with a synthetic graft.

14. What does vasotec (Enalapril Maleate) do/SE?
Vascular - artery disease causing fluid to back up into the lungs.
Lower HOB - place patient supine - assess LOC - open airway - assess breathing - get ambu bag - put on gloves - connect tubing from O2 source - adjust flow to 10 to 15 liters. First RESCUER: PLACE APEX of MASK OVER BRIDGE of NOSE And BASE BETWEEN LOW
Stop the medication - address the factors that may have precipitated the event. If life threatening Digibind ay be indicated.
Lowers BP and makes heart beat stronger. SE: flushed face.

15. What is a major complication of central line placement?
Pulse before and after giving.
Pneumothorax and will end up with chest tube to help reinflate lung.
Vascular - artery disease causing fluid to back up into the lungs.
One large emboli (smaller=better)

16. What lab value is used to evaluate a patient on coumadin? What is the normal value?
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
PT. Normal= 12 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PT= 18-30 sec.
Idiopathic

17. What is Raynauds disease? Tx?
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
Have the patient use the val salva maneuver when the line is being removed (bear down/hold breath) to prevent air from entering where the line was and causing a PE.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
Elevated legs - anticoagulation therapy (aggressive: generally IV heparin) - Be alert for signs of PE.

18. What are the signs and symptoms of left sided HF?
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
After a sheath removal to apply consistent pressure and prevent bleeding. (Ex: after swan ganz removal).
Paroxysmal nocturnal dyspnea - elevated pulmonary capillary wedge pressure - BLOOD TINGED SPUTUM - cough - orthopnea - exertional dyspnea - cyanosis.

19. What would make someone more at risk for digoxin toxicity?
Elderly - hypothyroidism - renal dysfunction - dehydration - HYPOKALEMIA - hypomagnesemia - or hypercalcemia. Patients with abnormal potassium levels have a higher risk because hypokalemia makes the heart more sensitive to digoxin.
The patient may suffer significant blood loss or femoral nerve compression.
A drop in systolic BP greater than 12 mm Hg during inspiration indicating a compromise.
Old truck driver or someone on bed rest or with pelvic trauma.

20. What are the steps to perform the heimlich maneuver?
Stand behind the victim - wrap arms around waist (IF PREGNANT WRAP ABOVE The BABy) - make a fist with one had and place thumb against abdomen midline - grasp fist with other hand - press into victims abdomen with quick upward thrusts.
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
Protamine Sulfate
When: using anticoagulants - liver disease - decrease in platelets (less than 150 -000) - hemophilia - using thrombolytic meds - DIC - CA - HIV - chemo - bone marrow problems - and ASA/NSAIDS.

21. What is you see an NA placing cardiac monitor electrodes on a patient. She is placing (-) on the left and (+) on the right what should you do?
Pallor - diaphoresis - tachypnea - severe tearing chest pain radiating to back - PULSES In ARMS Are STRONG BUT LEG PULSES Are WEAK - low SP02.
Don a protective gown - gloves - and goggles - call Dr - hand pt. emesis basin and raise the HOB 45* (at this angle he can spit out blood and prevent N&V/aspiration - have another nurse firmly press on his nose just below bony part (apply pressure at
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!

22. What should be taught upon discharge for someone going home on coumadin as a result of a PE?
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
Don a protective gown - gloves - and goggles - call Dr - hand pt. emesis basin and raise the HOB 45* (at this angle he can spit out blood and prevent N&V/aspiration - have another nurse firmly press on his nose just below bony part (apply pressure at
Need for follow up blood tests - Need to take oral warfarin for at least 3 months - and to reduce current risk encourage weight loss - smoking cessation - and regular exercise.
BP is elevated or decreased depending on activity.

23. What are the proper steps to changing a central venous catheter dressing?
It is a sterile procedure so both nurse and patient should wear a mask - arrange sterile field - remove dressing - assess the catheter insertion site for infection - put on sterile gloves - clean the site moving outwardly in a circular motion - apply
No clearly defined or measurable P waves and an irregular - irregular ventricular response.
In fatty areas or over major muscles - large breasts - or bony prominences.
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.

24. Where should you place your stethescope to find the tricuspid valve?
Awake and alert: IV lidocaine bolus and drip Unconscious - hypotensive - or S&S of angina/CHF: Direct current cardioversion and IV Lidocaine bolus and drip.
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
When a large air bubble blocks blood flow from the right ventricle into the pulmonary artery.
4th left intercostal space lower sternal border

25. In what locations should you not place electrodes?
IV LIDOCAINE BOLUS (50-100 mg) followed by an IV lidocaine drip (suppresses ventricular activity).
In fatty areas or over major muscles - large breasts - or bony prominences.
Right sided heart failure
They may feel a slight stinging under there tongue when they are dissolving - and they should get a HA (if no HA may not be good bc the pills only last for 6 months). Keep with you at all times.

26. What should you teach your patient about an exercise ECG (stress test)?
(S1 - S2) Third left intercostal space
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).

27. What should happen if someone converts to asystole/flatline?
Anxiousness - restlessness - tachycardia - tachypneic - 90% SP02 - dyspnea - substernal pain - coughing - hemoptysis - and fever.
ST segment elevation (STEMI)
CPR should be done. No defibrillation bc no rhythm to shock (heart already depolarized).
Need for follow up blood tests - Need to take oral warfarin for at least 3 months - and to reduce current risk encourage weight loss - smoking cessation - and regular exercise.

28. What is intermittent claudication?
NO TED HOSE - NO SHEETS/BLANKETS - NO COMPRESSION DEVICES - (TEACH NO OPEN TOES SHOES). Lambs wool is okay!
Demand: Works PRN (when HR goes below predetermined rate) or Fixed: beats constantly at predetermined rate so no matter what heart does still beats at same rate.
To reduce a patients risk of DVT and PE. They include graduated compression stockings - vena cava filters - and intermittent sequential external compression devices.
Leg pain that is brought on by exercise and relieved by rest. It is characteristic of peripheral artery occlusion/ arterial insufficiency. It is dull or cramp like and consistently occurs in the same area of the leg and with same amount of distance.

29. What are the nursing interventions for a patient in complete heart block?
Thromboanglitis obliterans/ Buerger's disease= inflammatory process of arterial wall - veins - and nerves where they become blocked. It is associated with smoking/tobacco use.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).
Open up blood vessels
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).

30. Which type of patient shouldn't take nitrates?
For the first month post op - do not lift more than 10 or 15 lbs. And avoid excessive pushing - pulling - or twisting.
A patient on sildenafil (Viagra) - Cealis - or Levitra bc these drugs together can cause very low blood pressure and heart attack.
Before
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.

31. What is an acute peripheral arterial occlusion?
Cardiac tamponade (fluid in pericardial space) and thickening/scarring of the pericardial sac (constrictive pericarditis and possible RHF).
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
International Normalized Ratio measures blood clotting time and compares it to normal values. 1.0=normal. Most people on anticoagulants are 2-3.
Positive Homan's sign (calf tenderness on dorsiflexion of the foot).

32. What drugs are most commonly used for angina?
Difficulty breathing - pain in midchest and shoulder - pale - nausea - and light headedness.
Direct current shock (defibrillation) and IV anti - arrhythmic drugs (lidocaine - Procainamide - and Bretylium).
Nitrates - Beta blockers - and Calcium channel blockers
4th left intercostal space lower sternal border

33. What is superior vena cava syndrome?
Patient who are unable to tolerate exercise stress testing.
Administer 100% O2 - left trendelenburg position - heparin administered - and oral warfarin started (give heparin and warfarin together for at least 5 days).
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
A complication from a venous access device or port. It is a blockage of the superior vena cava preventing superior blood flow from reaching the heart.

34. What is the necessary lab value to evaluate while a patient is on heparin? What is the normal value?
PTT. Normal= 30 sec. If on anticoagulants it should be between 1 1/2 to 2 1/2 x the normal value. For PTT= 45-75 sec.
Decrease in weight - diuretics (watch K loss) - aldactone (k sparing but check renal fx) - inderal (do Not give to asthma patients or diabetic patients) - more exercise - no smoking - and decreased Na intake.
Spasms of the arterioles in finger/toes (digits of hands/feet may fall off). Tx: stop smoking - avoid stress & cold - use a vasodilator (calcium channel blocker). No skiing or butcher for career.
Exercise and use graduated compression devices as directed - don't stand for long period of time - to avoid dislodging blood clots don't rub or massage your legs.

35. What SE should you look for with calcium channel blocker use?
Changing the way that you live is the first step. STOP SMOKING!!!! <30% FAT In DIET (don't avoid all fat) - lose weight - exercise - limit salt intake - nitro - Angioplasty (stent insertion) or CABG.
BP is elevated or decreased depending on activity.
Constipation or MAY CAUSE ANKLES TO SWELL (call healthcare provider).
Having the patient supine is ideal but any position is acceptable so long as in same position for each monitoring session - locate clean and dry sensor sites on the neck (in line with earlobe) and thorax (midaxillary at xiphoid process) - connect lea

36. What is characteristic of ventricular tachycardia?
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.
Rapid ventricular rate with no relationship to atrial activity and QRS complex is wide and bizarre.
It is an elective procedure - where the client is awake - it is synchronized with 'QRS' - the patient is sedated - a consent form must be signed prior to - they are placed on an EKG monitor - and they are shocked with 50-200 Joules.
Vitamin K (aqua myphiton)

37. What should be checked in a patient on a beta blocker?
(1st) Assess LOC - (2nd) if unconscious= begin CPR - and (3rd) Notify physician.
Pulse before and after giving.
BP is elevated or decreased depending on activity.
Nitrates - Beta blockers - and Calcium channel blockers

38. How should you palpate the carotid arteries?
MRI is painless - you must remain still inside a small/noisy space. If you are claustrophobic you may need sedation. Remove all jewelry and other metal objects. If you have any shrapnel - a pacemaker - or any surgically implanted joints - pins - clip
One at a time to assess the pulse amplitude and contour.
Need for follow up blood tests - Need to take oral warfarin for at least 3 months - and to reduce current risk encourage weight loss - smoking cessation - and regular exercise.
Leg pain that is brought on by exercise and relieved by rest. It is characteristic of peripheral artery occlusion/ arterial insufficiency. It is dull or cramp like and consistently occurs in the same area of the leg and with same amount of distance.

39. What are the five areas for listening to the heart?

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40. What should you teach your patient about an electrocardiogram (ECG)?
It is a noninvasive test that takes 15 mins. Electrodes are applied to sites on your body. You must lie still - relax - and breathe normally and remain quiet. Talking or moving distorts the images
If you feel lightheaded - dizzy - or heart palpitations but feel no shock from the ICD.
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches
The arteries have narrowed - decreased O2 to tissues= hypoxia to cells.

41. What are the nursing interventions for a patient with premature ventricular contractions?
Patient who are unable to tolerate exercise stress testing.
(1st) Assess the client for signs of decreased cardiac output and Notify the physician (2nd).
The physician injects a local anesthetic into the site - inserts a catheter - and threads it through the artery into the left side of the heart or through a vein into the right side of the heart to your lungs. Next - a dye is injected which may cause
Crushing chest pain that lasts 30 mins or longer and may radiate to the neck - shoulders - or jaw - diaphoresis - nausea - and SOB.

42. How is angina treated?

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43. Where is the apex/mitral valve landmark on the chest?
Fourth or fifth intercostal space at or medial to the midclavicular line.
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
Air answers (open junctions)
(1st) Assess the client for S&S of decreased cardiac output and Notify physician (2nd).

44. What causes secondary hypertension?
Whether the patients ulnar and radial arteries are patent.
Steroid treatment or a pregnant woman who is retaining water.
Pulse before and after giving.
It is calculated by checking the brachial BP and the ankle BP. The ankle systolic pressure is divided by the brachial systolic. The NA can perform. 0.97-1 is normal anything below indicates ischemia.

45. What body systems are affected by digoxin toxicity? S&S?
GI - neuro - and cardiac. S&S= yellow/green vision - N&V - bradycardia - and anorexia.
Aortic valve - Pulmonic valve - right ventricle - tricuspid valve - and apex or mitral valve.
Correct her and tell her that the (+) lead goes on the left and the (-) lead goes on the right side.
Fourth or fifth intercostal space at or medial to the midclavicular line.

46. What are the S&S associated with right sided heart failure?
Fatigue - JVD - Increased peripheral venous pressure - ascites - anorexia/complaints of GI distress - cyanosis - and dependent edema.
0.5-2.0 ng/ml
It is noninvasive. You must not eat - smoke - or drink alcohol for 3 hours before the test. WEAR COMFORTABLE SHOES And LOOSE LIGHTWEIGHT SHORTS OR SLACKS - YOU MAY GET AN INJECTION of THAllIUM - after your blood pressure and ECG are monitored for 10-
A hematoma= bleeding into the soft tissue surrounding the femoral artery access site.

47. What factors place you at risk for HTN?
BIRTH CONTROL PILL (LEADING CAUSE of HTN In YOUNG WOMEN-45=STILL YOUNG) - BLACK Male (then white male - than black female - then white female) - obesity - smoking - stress - high Na diet - lack of exercise - age - sex - race - or noncompliance.
You need to maintain use of those devices continually except when the patient is ambulating - bathing - or during physical therapy or skin assessment.
Put on gloves - remove the previous application paper and use a tissue to remove all ointment from the site to prevent overdose - squeeze the prescribed ointment in a thin layer onto a clean ruled application paper - choose an unused site on the ches
Right atrium - TRICUSPID VALVE (tissue) - right ventricle - PULMONIC VALVE (paper) - lungs - left atrium - MITRAL VALVE (My) - left ventricle - AORTIC VALVE (Assets). Tissue PAPER MY ASSETS!

48. Who would most likely have peripheral venous disease?
All People Enjoy Time Magazine= Aortic - Pulmonic - ERB's point - Tricuspid - and Mitral/Apex. P(2) E (3) T (4) MA (5) (locations)
Chest pain or discomfort that occurs when your heart doesn't get enough blood and oxygen. Stable: the feeling comes and goes at expected times. Unstable: the pattern of your pain has changed (longer - hurts more - etc.)
Old truck driver or someone on bed rest or with pelvic trauma.
Second right intercostal space

49. What are the S&S of superior vena cava syndrome?
Keep clean and dry for 72 hours - DON'T LIFT The ELBOW OR ARM ON The INCISION SIDE FOR FOUR WEEKS (CAN'T BRUSH HAIR OR TEECH BC PULLS CAN ROLL MARBLES) - DON'T LIFT PUSH OR PULL MORE THAN 10 LBS FOR FOUR WEEKS - take pulse and wt each day - CAll CARD
When not visable - place the patient in the left lateral position - ask them to exhale fully and stop breathing for a few seconds.
Explain procedure - stress importance of reporting symptoms. INSTRUCT The PATIENT NO TO EAT DRINK OR SMOKE AT LEAST 1 HOUR BEFORE The TEST. EVALUATE PATIENTS HISTORY FOR ANY CARDIAC CONDITIONS OR MEDICATIONS THAT MAY INTERFERE WITH The TEST!!! (No va
Feeling of fullness in head - tightness around shirt collar - or rings/jewelry that suddenly seem tight - swelling in face - hands - arms - and swollen/cyanotic lips - dyspnea - coughing - hoarseness - chest pain - hemotysis - visable collateral ches

50. How long is contrast media in the body?
INTERVENE: to control edema and decrease pain patient should be on bed rest with legs elevated six inches above heart level.
Clip the hair to allow good contact between the electrodes and the skin (DONT SHAVE).
Trendelenburg position for insertion. Pt holds breath to prevent air from entering sinus tract.
Only for a few hours