Chest Tube Flashcards
Chest tubes do what to the lungs?
How do they do that ?
Why do you need negative pressure
Chest tubes re-expand the lungs
By Re-establish negative pressure in the pleural space (need negative pressure for air
exchange) so that lung expands when the chest wall moves
Collection chamber
When do you need to record the drainage ? You are making sure for ?
When do your notify the doctor? What does it indicate.
Record the drainage every 8hrs or every shift . You are making sure you know how much that patient has put out during your shift. also look at it at the beginning of your shift to know your starting point
Notify the doctor if the drainage is greater then 100 ML/hr or bright red . More then 100ml indicators your patient could be hemorrhaging! Bright red blood means fresh/new blood
The Water Seal makes sure ?
What is a bad sign and good sign in the water seal Chamber?
It’s a one way valve . It make sure nothing comes in
while air comes out.
Bubbling
Continuous -bad sign
Intermittent -good sign
Suction chamber is basically?
Where is it connected ?
Who controls how much suction a patient receives?
Is Continuous bubbling good or bad ?
Is Intermittent bubbling good or bad?
How much suction your patient is getting.
This is suction that connected to the wall that is a continuous suctioning .
The doctors determine how much low wall suction a patient should have on the chest tube
Yes , means suction is on
Bad means suction is not functioning properly so u need to check that tubing
Care of a client with a chest tube (6)
1) _assee client for ___________ ______________, and_______
________________.
2) Chest tubes should be placed ______________ chest level.
3) Do not_____ or____ tube without M.D. order.
4) ___________ _________ are needed to check fluid removal
5) Clients will have ___________ __________ at insertion site.
6) Never ___________ a chest tube without a M.D. order.
Care of a client with a chest tube
1) __Assess client for _
respiratory distress ,breath sounds and
stable vital signs __________
2) Chest tubes should be placed ___bleow chest level.
3) __do not milk/strip chest tube without M.D. order.
4) _ daily x-rays are needed to check fluid removal
5) Clients will have _occlusive dressing at insertion site.
6) Never __clamp a chest tube without a M.D. order. Unless it’s a emergency situation
Always have 3 Things at the bed side with a chest tube ?
- ) Occlusive dressing
- )clamp
- ) sterile water
atelectasis=
Lung collapsed
What is the purpose of a chest tube
purpose: re-establish negative pressure in the pleural space (need negative pressure for air
exchange) so that lung expands when the chest wall moves
The pleural space is a place where negative is ___? and why
Good because negative make things stick together
pnemothorax (______ = ___ pressure.. put chest tube in to re-establish negative pressure!)
hemothorax (_______= ______ pressure.. put chest tube in to re-establish negative pressure!)
pneumohemo (______ = __ pressure.. put chest tube in to re-establish negative
pressure!)
pnemothorax (air = positive pressure.. put chest tube in to re-establish negative pressure!)
hemothorax (blood= positive pressure.. put chest tube in to re-establish negative pressure!)
pneumohemo (air & blood = positive pressure.. put chest tube in to re-establish negative
pressure!)
What are the locations of the tubes?
APICAL and BASILAR
APICAL=
BASILAR=
APICAL (high; air) because air rises
& BASILAR (bottom; blood) blood is subject to gravity
Is chest trauma: : unilateral or bilateral
chest trauma: unilateral (always assume its unilateral)
They will have 2 on the side of surgery .
How many chest tubes for post op R pneumonectomy ?
post total pneumonectomy (no chest tube!!)
Because pneumonectomy means removal of lungs
Problem Solving
- What do you do if you kick over the collection bottle?
Problem Solving
- What do you do if you kick over the collection bottle?
a. Not a big deal; can just sit it right back up; have take a couple deep
breaths
Problem solving
What do you do if the water seal breaks?
In routine care never do it?
Why is it better to be underwater then to be clamp?
What do you do if the water seal breaks?
a. This is more serious, because it is allowing air in creating a 2 way
b. First: Clamp chest tube (Better no way than 2 way for brief period of
time) **in routine care never clamp chest tube!!
c. Best: Submerge
i. Cut tube away (down) by device; submerge under water
preferably sterile-then unclamp
- )Clamp
- )cut
- )submerge
- ) unclamp Because you reestablish the water seal. It doesn’t need clamp as long as it’s under water
in routine care never clamp chest tube!!
Because air can’t go in but stuff can’t come out! If it’s clamp nothing can go in or out. Andre want stuff to come out not go in
Problem solving
What do you do if the chest tube comes out?
First: cover hole with gloved hand; occlusive (Vaseline gauze) dressing; 3
sided sterile dressing; tape
b. Best: occlusive dressing (Vaseline gauze )
Rules for clamping the tube
What happens if you break the water seal?
How long do you have to get it
under water?
Have ____ nearby!
Never clamp for longer than 15 seconds without a Dr.’s order
b. Use rubber tipped double clamp So u want puncture it
What happens if you break the water seal? CLAMP it! How long do you have to get it
under water? 15 seconds, or you gotta unclamp.. Have sterile water bottles nearby! Use rubber
tip double clamps
*If something is sealed, should you have a continous bubbling?
No
