chest tubes

Question 1

what is a pleural effusion?

Answer 1

fluid in the pleural space

Question 2

pleural effusion r/f

Answer 2

CHF
chronic liver disease
trauma
pneumonia

Question 3

pleural effusion s/s

Answer 3

cough
dyspnea
dull percussion
chest pain on inspiration
decreased breath sounds

Question 4

chest tube nursing management

Answer 4

maintain patency
watch for air leak
fluid levels
monitor infection
incentive spirometry
vitals and lung sounds q4hrs
deep breathing
keep below chest
document drainage amount

Question 5

at what mL do you call dr?

Answer 5

over 100 mL

Question 6

when do you remove chest tube?

Answer 6

when lungs re-expand and drainage is minimal

Question 7

chest tube removal interventions

Answer 7

pre-medicate
valsalva maneuver (exhaling over closed airway)
apply occlusive dressing
chest xray
monitor for respiratory distress
NO MILKING

Question 8

bubble airleak

Answer 8

bubbling in chamber
check connections
notify physician
(if it stops after clamping tube, it is coming from patient)

Question 9

water suction

Answer 9

amount of water in chamber

suction to lungs, filled -20cm
want gentle bubbling in 3rd chamber

Question 10

dry suction

Answer 10

no water, dial, must ventilate to decrease pressure