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12 Cards in this Set
- Front
- Back
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Purpose of Chest Tubes
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- Removes unwanted materials from pleural cavity allowing the lung to reexpand.
- Must also prevent air from being pulled into chest cavity |
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Components of a Chest Tube
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- Unobstructed chest tube
- Collection chamber - One way mechanism (water seal) |
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Chest tubes TYPES
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- Pneumothorax – chest tube placed high
- Hemothorax – chest tube place low |
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Define the One way mechanism
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- Simplest way is with water seal
- Done by placing the distal end of the drainage tube in about 2 cm of water - Air can be forced out but air can not be drawn back into the chest. - Some newer chest tube system have one way flutter valve |
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One bottle system
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- Rigid straw in container
- Straw is submerged under 2 cm of water - Exit vent allows pleural air to escape into the atmosphere. - Problem: -- If blood was coming out, then it increases volume in container, causing change in pressure to evacuate fluid in pleural cavity |
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Two bottle system
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- Drainage falls into the collection bottle and air flows into the separate water seal bottle
- Allows more accurate observation of volume and type of drainage - Can also add suction to help pull out substance in chest - Supplemental suction is hard to control, though |
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Three bottle system (The new standard)
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- Safest way to regulate the amount of suction
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Summary of Procedure to assist in insertion of CT
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- Explain procedure to pt-get consent
- Gather equipment - Set up drainage system-instructions on package - Position the patient according to physician’s wishes - Assist physician with insertion (sterile procedure) - Connect the end of the CT to drainage-tape connections - Apply dressing - Connect to suction if ordered - Adjust tubing so no dependent loops - document |
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CT Procedure Care: PATIENT ASSESSMENT
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- RR, vital signs
- Breath sounds - Changes in LOC/restlessness - O2 sats - Subcutaneous emphysema - Dressing |
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CT Procedure Care: DRAINAGE ASSESSMENT
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- Color
- Amount - DO NOT EMPTY - Document at least every 8 hours - Just draw line on bottle when you documented time/date) - If system needs to be changed, then get new system, clamp chest tube, separate chest tube from system tube, add new system, unclamp tube - If tube is clamped for a long time, it causes tension pneumothorax, causing the good lung to collapse |
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CT Procedure Care: Chest tube system assessment
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- Tubing free of kinks and dependent loops
- System upright and below insertion site - Check for fluid fluctuations with breathing - Check for bubbling (air leak) - Check for suction-amount, fluid level |
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What do you do if the chest tube comes out?
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Cover the opening and call for help!
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