Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
Why would a chest tube be placed higher in the body vs lower in the body?
|
A tube would be higher for air to escape, lower to drain fluid
|
|
|
Pneumothorax
|
Complete or partial collapse of the lung r/t accumulation of air in the intrapleural space
|
|
|
Hemothorax
|
Accumulation of blood b/w chest wall & pleural space
|
|
|
What is an open vs closed pneumothorax?
|
Open is open thru tissue going to area open to the outside world. Closed is not open to outside world
|
|
|
A mechanical ventillator, subclavian central line, or a rib fracture could cause what kind of pneumothorax?
|
Closed - no external wound
|
|
|
A spontaneous closed pneumothorax could be caused by a ruptured bleb, what is this?
|
A bleb is a collection of air within layers of the viceral pleura in the pleural space- rupturing would cause a closed pneumothorax
|
|
|
A pentrating chest wound, like gun shot, knife, thoracotomy, would cause what?
|
An open pneumonthorax- DONT REMOVE OBJECT
|
|
|
What is the collectiion of air in the pleural space and air is not allowed to escape during expiration causes what?
|
Tension pneumothorax
|
|
|
How would a pt with a tension pneumothorax present clinically?
|
↑ air accumulation, trachea pulls to unaffected side, compressing cardiac vessels=> ↓ CO
|
|
|
Clamping off a chest tube cause cause?
|
Tension pneumothorax
|
|
|
Chest trauma, lung CA, complicatons of anticoagulant therapy, pulmonary embolisms, can cause a what, usually related to an open pnuemothorax?
|
Hemothorax
|
|
|
What would we call it when a fracture of 2 or more adjacent ribs in 2 or more places => instability of chest wall?
|
Flail chest
|
|
|
A rapid collection of blood in pericardial space, causing pressure on the heart therby decreasing cardiac output is called?
|
Cardiac tamponade
|
|
|
If a pt has SOB, pain, ↓ movement on injured side, & ↓ breath sounds on injured side, pt could have?
|
Pnuemothorax or hemothorax, S&S =SAME
|
|
|
What is the emergency management of a pt coming in with a pneumothorax?
|
Insertion of a large bore needle wiht air release valve, chest tube to water seal suction
|
|
|
What would this emergency management be treating?
Inserting chest tube, aspirating pleural cavity, treating hypovolemic shock |
Hemothorax
|
|
|
What do these s&s suggest?
Cyanosis, air hunger, trachial deviation to side, subcutaneous emphysema? |
Tension pneumothorax
|
|
|
What are the emergency managements of a tension pneumothorax?
|
Inserting a chest tube or large bore needle to release air, treat hypoxia
|
|
|
What are the 3 chambers of the chest tube drainage system?
|
Suction control chamber, air leak chamber (water seal), drainage chamber
|
|
|
The air leak chamber should be filled to ? You should know flunctuations or what? when controlled by water seal suction? There should be NO what in chamber??
|
2 cm, note tidaling, should be NO BUBBLES IN CHAMBER
|
|
|
What can a lack of drainage in the chest tube of a pt with a hemothorax tell you ?
|
The tube might have a clot stopping the tube.
|
|
|
If the tube has a clot clotting it off, what should you do?
|
Try milking the tube, ONLY IF ORDERED TO DO SO. Start at proximal end gently squeezing and releasing it between your fingers along the length of the tubing.
|
|
|
Should we strip the chest tube?
|
NO, NO NO. (squeezing the length of the tube without releasing it) Stripping causes a dangerous increase in intrathoracic pressure and doesnt lead to significant output
|
|
|
What should you always have in the room in case the water seal gets cracked and starts bubbling?
|
A bottle of normal saliene to stick it in until you get a new unit
|
|
|
When coming into the room, what should you check for in the pt with chest tubes?
|
Respiratory distress, chest pain, breath sounds over lung area, and stable vital signs
|
|
|
If pt assessment is good, what should you check with the chest tube unit ?
|
Dressing, tube is patenet
Kinks in tubing, loops, or clots Chest drainage system 2 hemostats attached to top of pts bed with tape!!!! |
|
|
What are the five circumstances we would use a hemostat on a pt with a chest tube?
|
1.To assess an air leak
2. Quickly Empty or change collection bottle/chamber 3. Change to new system 4. To assess if pt is ready to have chest tube removed |
|
|
What position would be best for a pt with a pneumothorax?
|
Semi-fowlers
|
|
|
What position would be best for a hemothorax?
|
High fowlers
|
|
|
When do we milk a chest tube?
|
ONLY MD/PA ORDERS!!!???
|
|
|
What do you do if a chest tube becomes dislodged?
|
Immediately cover the site with a sterile dry dressing & call MD
|
|
|
What should you do if you hear air leaking from the site of the hole where the tube goes?
|
Tape the dressing on two-3 sides to allow air to escape and prevent a tension pneumothorax
|
|
|
You walk into a room and you see continuous bubbling in water seal chamber, indicatiing there is a leak between pt and water seal. what do you do?
|
Tighten loose connection. If that does not work, cross clamp chest tube close to pts chest. If bubbling stops, air leak is inside pt thorax or chest tube insertion site. Unclamp tube and notify MD immediately! Reinforce chest dressing
|
|
|
Leaving a chest tube clamped causes
|
Tension pneumothorax & mediastinal shift
|
|
|
If you clamp by pts chest and its still bubbling, what does this mean and what do you do?
|
Leak is not in pt chest or at insertion site. Move clamp down drainage tubing away from pt
|
|
|
If you move the clamp all the way down the tubing and it continues to bubble, what should you do?
|
Mean there is a leak in the drainage system. Change this out.
|
|
|
How do you change a chest drainage unit to a new one?
|
Remove the current drainage system from suction, clamp chest tube with a rubber tipped hemostat, and disconnect tubing from old CDU. Connect to new CDU, unclamp tubing!, secure all connections, start up suction, assess for proper function
|
