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376 Test 2 > Chest Tube > Flashcards

Chest Tube Flashcards

1
Q

Pleural space lies between the _____ and _____ pleara of the chest wall and lungs.

A

between the parietal and visceral

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2
Q

Signs of a pneumothorax?

A
  • Tachypnea
  • tachycardia
  • decreased/absent breath sounds
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3
Q

Symptoms of a pneumothorax?

A
  • pain worse on inspiration
  • dyspnea
  • cough
  • sudden stabbing pain
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4
Q

Chest wall intact, penetration of pleural space is called…

A

Closed pneumothorax, air enters the pleural space from the lung

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5
Q

chest wall and pleural space penetrated is called…

A

Open pneumothorax, air enters in from the outside

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6
Q

What is a Hemothorax?

A

blood in pleural space

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7
Q

What is a hemopneumothorax?

A

Blood and air in pleural space

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8
Q

Treatment for a hemopneumothorax?

A

two chest tubes

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9
Q

Placement of chest tubes?

A 
1  - at apex, 2nd intercostal space to drain air 
#2 - between the 5th or 6th
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10
Q

What is a tension pneumothorax?

A
  • 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
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11
Q

Signs and symptoms of a tension pneumothorax?

A
  • rapid, labored respirations
  • tachycardia
  • cyanosis
  • hypoxemia
  • chest pain that extends to shoulders
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12
Q

What is a pleural effusion and what causes one?

A

excess fluid in the pleural space

- caused by left ventricle failure, pulmonary embolism, pneumonia, cancer, tumors

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13
Q

What is a chylothorax and what are the causes?

A
  • 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)
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14
Q

What is empyema?

A

purulent drainage from infection (pneumonia or lung abscess)

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15
Q

Signs and symptoms of empyema?

A
  • cough
  • chest pain
  • SOB
  • fever
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16
Q

Treatment for empyema?

A

Thorocentesis - a procedure to remove excess fluid in the space between the lungs and the chest wall

17
Q

When is chest drainage needed?

A

when negative pressure in the pleural cavity is disrupted, by air/fluid resulting in pulmonary compromise

18
Q

What is the purpose of chest drainage unit?

A

evac air/fluid to re-establish negative pressure

19
Q

What is pleurodesis?

A

A tube that is placed in the pleural space to instill fluid (chemo, sclerosing agent)

20
Q

Chest drainage unit chamber assessment items?

A
  • color
  • quantity, mark on collector
  • type
21
Q

Milk or Strip to remove clots from a chest tube?

A

MILK…. never strip

22
Q

What is tidaling in a chest drainage unit?

A
  • indicates pressure changes in pleural space, up with inspiration and down with expiration
23
Q

What should you do if you don’t see any tidaling?

A

NOTHING SILLY! Lack of tidaling means the lungs is staying re-expanded. It’s a muricle!!!!

24
Q

Chest tube assessment tasks?

A
  • Vitals Q2hr
  • RR, depth, pattern, ease
  • breath sounds
  • heart sounds (present, clear, muffled/distant, cardiac tamponade)
  • skin color and temp
25
Q

What is cardiac tamponade?

A
  • Fluid/blood/clot accumulates in pericardium

- Heart rate may decrease and BP increase

26
Q

Mr. Claus’s is two days s/p chest tube insertion, upon palpation of the chest you hear what sound like rice krispies and notice swelling in the face, neck, and chest. What would you suspect?

A

Subcutaneous emphysema, occurs if air leaks from the pleural space into the subcutaneous tissues

27
Q

There is a leak in Mr. Claus’s chest tube, how do you locate where the leak is?

A

Start by clamping at the patients chest, if leak stops its the patient leaking. If leak continues move down the tube clamping intermittently to find the leak

28
Q

You walk into Mr. Claus’s room and see his chest tube on the floor, it has completely come out. What is your first action?

A

Cover the site with Vaseline gauze to prevent external air from entering the chest

29
Q

How long can you leave a clamp on Mr. Claus’s chest tube?

A

no more than 1 min

30
Q

What should you keep at Mr. Clause’s bedside?

A
  • Vaseline gauze
  • one bottle of sterile water
  • 1 roll of cloth tape
  • 2 pairs padded Kelly clamps
31
Q

You notice there are fluctuations in the water seal chamber of Mr. Claus’s chest tube unit. Is this an indication that the tube is ready to come out?

A

NO, the opposite is true. An indication the Mr. Claus’s tube is ready to be removed is that fluctuations have stopped

376 Test 2 (6 decks)

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