Chest Tube Flashcards
Pleural space lies between the _____ and _____ pleara of the chest wall and lungs.
between the parietal and visceral
Signs of a pneumothorax?
- Tachypnea
- tachycardia
- decreased/absent breath sounds
Symptoms of a pneumothorax?
- pain worse on inspiration
- dyspnea
- cough
- sudden stabbing pain
Chest wall intact, penetration of pleural space is called…
Closed pneumothorax, air enters the pleural space from the lung
chest wall and pleural space penetrated is called…
Open pneumothorax, air enters in from the outside
What is a Hemothorax?
blood in pleural space
What is a hemopneumothorax?
Blood and air in pleural space
Treatment for a hemopneumothorax?
two chest tubes
Placement of chest tubes?
1 - at apex, 2nd intercostal space to drain air #2 - between the 5th or 6th
What is a tension pneumothorax?
- air leaks into pleural space through a tear in lung and has no way to escape
- positive pressure compresses lung shifting the mediastinum to unaffected side
- venous return and cardiac output decreased
Signs and symptoms of a tension pneumothorax?
- rapid, labored respirations
- tachycardia
- cyanosis
- hypoxemia
- chest pain that extends to shoulders
What is a pleural effusion and what causes one?
excess fluid in the pleural space
- caused by left ventricle failure, pulmonary embolism, pneumonia, cancer, tumors
What is a chylothorax and what are the causes?
- thoracic duct leaks lymphatic fluid (milky white) in the pleural space, diagnosed by CT scan
- chest trauma, expanding tumor, cardiac surgery (or other surgeries on the mediastinal structures)
What is empyema?
purulent drainage from infection (pneumonia or lung abscess)
Signs and symptoms of empyema?
- cough
- chest pain
- SOB
- fever
Treatment for empyema?
Thorocentesis - a procedure to remove excess fluid in the space between the lungs and the chest wall
When is chest drainage needed?
when negative pressure in the pleural cavity is disrupted, by air/fluid resulting in pulmonary compromise
What is the purpose of chest drainage unit?
evac air/fluid to re-establish negative pressure
What is pleurodesis?
A tube that is placed in the pleural space to instill fluid (chemo, sclerosing agent)
Chest drainage unit chamber assessment items?
- color
- quantity, mark on collector
- type
Milk or Strip to remove clots from a chest tube?
MILK…. never strip
What is tidaling in a chest drainage unit?
- indicates pressure changes in pleural space, up with inspiration and down with expiration
What should you do if you don’t see any tidaling?
NOTHING SILLY! Lack of tidaling means the lungs is staying re-expanded. It’s a muricle!!!!
Chest tube assessment tasks?
- Vitals Q2hr
- RR, depth, pattern, ease
- breath sounds
- heart sounds (present, clear, muffled/distant, cardiac tamponade)
- skin color and temp
