Chest Tubes Flashcards
What organs are found in the thoracic cavity?
- Lungs
- Heart
- Diaphragm
- Trachea
- Esophagus
- Bronchial tubes
- Lymph nodes
How do the pressures inside the thoracic cavity change as a person breathes in and out?
- always negative pressure in the pleural cavity
- degree of negativity changes during respiration
- normal inspiration, intrapleural vacuum pressure is approximately - 8cmH2O
- during expiration the vacuum pressure falls to -4cmH2O
where are the parietal and visceral pleura?
parietal pleura
- membrane that lines the inside of the rib cage
viceral (pulmonary) pleura
- membrane coming the lungs
how much fluid is normally found in the pleural space?
small amount of lubricating fluid so membranes slide smoothly against each other
What is a pneumothorax?
- air in the pleural space
- collapsed lung
What is a hemothorax?
blood in the pleural space
what is a pleural effusion?
build-up of excess fluid between the layers of the pleura outside the lungs
what are the 2 types of pneumothorax?
- open
- closed
describe a closed pneumothorax
- No associated external wound
- Most common form is a spontaneous pneumothorax > accumulation of air in the pleural space without an apparent antecedent event
when does a closed pneumothorax occur most commonly?
- underweight male cigarette smokes between 20-40 years
- rupture of small bleb
describe an open pneumothorax
- Occurs when air enters the pleural space through an opening in the chest wall
- Air can freely move in/ out of the pleural space through the hole in the chest wall
- Also known as sucking chest wound
When does an open pneumothorax occur most commonly?
- gun shot wound
- stabbing
- any empaling in the thoracic cavity
What is a tension pneumothorax?
- Air in pleural space that does not escape
- Continued increase in amount of air shifts intrathoracic organs and increases intrathoracic pressure
Why is a mediastinal shift dangerous to the patient?
- causes the entire mediastinal area, including the heart, aorta, bronchial tree and other structures to be pushed toward the unaffected side
- reduce size of the unaffected lung chamber and make breathing very difficult
Why is suction often used for patients on chest tube drainage?
aids in getting negative pressure back and maintaining it during drainage
How is the amount of suction regulated on a chest drain?
- Through the amount of suction turned on through the wall mount which is then connected to the drainage system
Why should the chest drainage unit be kept below the level of the patient’s chest?
Maximize drainage efficiency
How would the nurse recognize if a patient has an air leak?
bubbles in the water chamber
What are the 3 chambers or compartments in a disposable chest drainage system?
- Water-seal chamber
- Suction control chamber
- Collection chamber
Why would a chest tube be placed in the mediastinal space?
prevent cardiac tamponed
after thoracic surgery, what type of drainage might the nurse see?
- sanguineous
what is the purpose of the water seal chamber?
- Allows visual detection of air leaks
- Air bubbles passing through the graduated air leak monitor help assess the air leak patterns and patient air leak trends
What does it mean if the nurse sees consent bubbling in the water seal chamber?
- Air leak in the system somewhere
- Air leak independent of patients breathing
What does it mean if there is NO bubbling in the water seal chamber?
- No air is being passed through tubing
- Good scenario for fluid drainage
- Bad for pneumothorax