Chest Tubes Flashcards
Chest tubes are inserted into…
The pleural space
What is the pleural space?
It is the “potential” space between the parietal and visceral pleural
A breach in the pleural integrity allows what to enter the pleural space?
Air or fluid
Why is air/fluid in the pleural space a negative thing?
This condition prevents lung expansion and rapidly progresses to respiratory insufficiency, cardiovascular collapse, and ultimately death if unrecognized and untreated.
What is a tension pneumothorax?
A tension pneumothorax is a life-threatening condition that develops when air is trapped in the pleural cavity under positive pressure, displacing mediastinal structures and compromising cardiopulmonary function.
What is the immediate tx for a tension pneumothorax?
Thoracentesis to relieve immediate situation followed by chest tube insertion
True or False
Chest tube insertion is always done in the Operating room.
- False
- Pending the situation, it is performed bedside, in the OR, or a interventional radiology suite
If possible, what must be obtained prior to chest tube insertion?
CONSENT!
What is the contraindication for the use of a sedative or analgesic agent prior to chest tube insertion?
Not to be used for those WITH artificial airways
After chest-tube insertion, the patient may lose ____ milliliters of blood or transudate, potentially leading to _____.
- several hundred
- hypotension
What should be done if there is an air leak at the chest tube insertion site?
Notify HCP immediately!
True or False
Its ok to milk, strip or clamp the tube while providing care.
- FALSE
- Its never ok to do any of those things!
What is a Hemopneumothroax?
A pneumothorax caused by blood in the pleural space rather than air
What must be done to restore a PT w/ a chest tube due to pneumothorax to normal function?
all air and fluid must be removed, and the source of an air leak must be closed.
True or False
Positive pressure outside the lung keeps the lung in a fully expanded position.
- False
- Negative pressure would do that
Upon assessment of a PT with SOB, you notice there is a deviation of the trachea to the left. What is the immediate thought as to reason?
Pressure from a pneumothorax of the right lung
What is a Thoracostomy?
A procedure to make an opening in the chest wall to insert a chest tube
Intermittent bubbling in the water seal chamber upon expiration indicates…
A leak
Continuous bubbling in the water seal chamber indicates…
A large leak between the drain and PT
If a water seal leak is present, what is the Nurse’s course of action?
- Check drain for disconnection, dislodgement and loose connection, and assess patient condition.
- Notify medical staff immediately if problem cannot be remedied.
- Document on Fluid Balance Chart
If the patient needs to be transferred to another department or is ambulant, the suction should be…
disconnected and left open to air.
Why do we not clamp a chest tube?
It may cause a pneumothorax
For treatment of pleural-space disruptions, chest-tube therapy should focus on what three primary objectives?
- Removing air and fluid as promptly as possible
- Preventing drained air and fluid from returning to the pleural space
- Restoring negative pressure within the pleural space to re-expand the lung.
