CHEST TUBE THORACOSTOMY

Question 1

done to drain fluid, blood, or air from the space around the lungs.

To restore negative pressure.

Answer 1

Chest tube thoracostomy

Question 2

Chest tube thoracostomy is done to remove

Answer 2

air (pneumothorax)
blood (hemothorax)
fluid (pleural effusion)
pus (empyema)

Question 3

AIR outside the lung but within the pleural cavity

Answer 3

PNEUMOthorax

Question 3

Pus from the intrathoracic space.

Answer 3

emPyema

Question 4

Blood collects in your pleural space

Answer 4

HEMOthorax

Question 5

CHEST TUBE THORACOSTOMY
is used to remove air from the intrathoracic space.

Answer 5

pneumothorax

Question 6

buildup of too much fluid between the layers of your pleura around your lungs

Answer 6

Pleural effusion

Question 7

chest tube other names

Answer 7

chest drain or tube thoracostomy

Question 8

is a flexible plastic tube that inserted through the side of the chest into the pleural space.

Answer 8

chest tube (chest drain or tube thoracostomy)

Question 9

It drains blood from the lungs

Answer 9

chest tube

Question 10

in PREPARATORY PHASE of chest tube insertion, patient will be assessed for

Answer 10

pneumothorax, hemothorax, presence of respiratory distress.

Question 11

what is obtain in preparatory phase of assisting with chest tube insertion

Answer 11

chest x-ray

Question 12

Other means of localization of pleural fluid

Answer 12

ultrasound, fluoroscopic localization

Question 13

Phases in assisting with chest tube insertion

Answer 13

preparatory phase, performance phase, follow up phase

Question 14

Observe the drainage system for blood/air. Observe for fluctuation
in the tube on respiration.

what phase of assisting with chest tube insertion?

Answer 14

FOLLOW – UP PHASE

Question 15

• Secure a follow-up chest x-ray.
• Assess for bleeding, infection, leakage of air and fluid around the tube.

what phase of assisting with chest tube insertion?

Answer 15

Follow up phase

Question 16

Assess patient’s pain at insertion site and give medication appropriately. If patient is in pain, _ will hampered.

Answer 16

chest excursion and lung inflation

Question 17

Maintain chest tubes to provide

Answer 17

drainage and enhance lung
reinflation.

Question 18

in chest tube thoracostomy, Keep the patient in a

Answer 18

propped-up position (45-90 degree)

Question 19

Always ensure the correct position of the UNDERWATER SEAL BOTTLE.
– The bottle should be

Answer 19

erect and at least 100 cm BELOW the level of the patient’s chest.

Question 20

The TIP OF THE GLASS TUBE that connects to the chest drain should be at least - below the fluid level in the bottle

Answer 20

2 cm

Question 21

The tip of the glass tube that connects to the chest drain should be at least 2cm below the fluid level in the bottle
(and not - below the fluid level).

Answer 21

more than 7 cm

Question 22

Swinging or oscillation of the column of water in the glass tube connected to the chest drain is monitored every

Answer 22

4 hours:

Question 23

monitored every 4 hours

Answer 23

1. vital signs 2. swinging/oscillation 3. blowing/bubbling (if theres bubbling in drainage bottle = lung is still leaking air) 4. vital signs

Question 24

need to be monitored every 4 hours: Blowing or air bubbling in drainage bottle with quiet respiration and on coughing (Bubbling of air indicates that the

Answer 24

lung is still leaking air.

Question 25

the following items need to be monitored every 4 hours in chest tube thoracostomy

Answer 25

vital signs, Swinging or oscillation of the column of water, Blowing or air bubbling in drainage bottle, dressing site

Question 26

When chest tubes are inserted, they must be connected to a - that allows air and fluid to be removed from the chest cavity but prevents air from entering the outside

Answer 26

sealed drainage system or one way valve

Question 27

sealed drainage systems typically have a

Answer 27

suction control chamber, a water seal chamber and a closed collection chamber for drainage

Question 28

system that when the client inhales, the water prevents air from entering the system from the atmosphere.

Answer 28

water seal system

Question 29

- can be added to the system to facilitate removing air and secretions from the chest cavity.

Answer 29

Suction

Question 30

in chest tube thoracostomy, Assess the

Answer 30

vital signs, oxygen saturation, cardiovascular status and respiratory status.

Question 31

Check breath sounds - and check for symmetry of breath sounds

Answer 31

bilaterally

Question 32

in chest thoracostomy, this must be done every 2 hours

Answer 32

* Encourage deep breathing and coughing exercises * Reposition client

Question 33

Avoid aggressive chest tube manipulation if necessary - such as squeezing hand over hand along the tubing and releasing the tubing between squeezes may help improve patency

Answer 33

gentle technique

Question 34

Avoid clamping the tube as this increase the risk of You can clamp the tube for a moment to replace a drainage unit or to locate the source of leak

Answer 34

tension pneumothorax.

Question 35

If the tube becomes disconnected from the collecting system, submerge the end in 1 - to maintain the seal

Answer 35

sterile water

Question 36

If unadvertently pulled out, the wound should be cover with a -

Answer 36

dry sterile dressing

Question 37

When transporting and ambulating the client: a. Keep the water seal unit - b. Disconnect the drainage system from the suction apparatus before moving the client make sure that the air vent is open

Answer 37

below chest level and upright

Question 38

– The cessation of bubbling during both quiet respiration and coughing indicates that the air leak in the lung has .)

Answer 38

closed

Question 39

Type and quantity of drainage (Inform practitioner if drainage is

Answer 39

>100 mL/h or if frank blood.

Question 40

Never lift the drainage bottle above the level of the patient’s chest, as fluid from the bottle may - off into the patient’s chest.

Answer 40

siphon

Question 41

Keep - (angled) at the bed side.

Answer 41

2 clamps

Question 42

Do not clamp a - chest drain.11

Answer 42

bubbling

Question 43

- the tubes frequently to avoid blockage by fibrin plugs or clots.

Answer 43

"Milk"

Question 44

Change the connecting tube and bottle at least - and replace them with sterile equivalents.

Answer 44

once every 48 hours

Question 45

REMOVING CHEST TUBES ASSESSMENT Lung reexpansion is complete when: * Chest x-ray film reveals

Answer 45

total lung reexpansion

Question 46

ASSESSMENT Lung reexpansion is complete when: * Water-seal fluctuation has stopped for

Answer 46

24 hours.

Question 47

ASSESSMENT Lung reexpansion is complete when: Drainage is decreased to

Answer 47

less than 50 Ml/day

Question 48

ASSESSMENT Lung reexpansion is complete when: * Percussion reveals

Answer 48

tympany.

Question 49

ASSESSMENT Lung reexpansion is complete when: * Auscultation of lungs reveals breath sounds are - throughout the chest cavity

Answer 49

present

Question 50

REMOVING CHEST TUBES ASSESSMENT Clamp chest tube - hours before removal, or as ordered by the physician. Assess for changes in vital signs, chest pain, and level of apprehension.

Answer 50

12 to 24

Question 51

REMOVING CHEST TUBES IMPLEMENTATION * Assist client to sit - or to lie on the side without chest tubes,

Answer 51

on edge of bed

Question 52

REMOVING CHEST TUBES IMPLEMENTATION Prepare an occlusive dressing of - on a pressure dressing and sets it aside on a sterile field.

Answer 52

petroleum gauze