Chest Tubes Flashcards
What are indications for a chest tube?
Pneumothorax, hemothorax, pleural effusion
If our patient’s chest tube line is clotted, what should we do?
Don’t milk/strip it. Try and get the clot out with gravity and if that doesn’t work get new tubing/new set.
What is a complication of a pneumothorax?
Tension pneumothorax
What are the manifestations of a tension pneumothorax?
SOB, increased HR, hypoxia, pleuritic CP, cyanosis, mediastinal shift/tracheal tug
What are nursing assessments for a patient with a chest tube?
Respiratory, VS, tracheal alignment.
What is the wall suction usually set at for a chest tube? What is the setting usually on the drainage system?
- -20.
What is something that can occur because of a chest tube insertion?
Subcutaneous emphysema
Where would chest tubes be located if the patient has a pneumothorax? What about a hemothorax? After heart surgery?
Upper/lateral chest. Lower/lateral chest. On either side of sternum.
What are heimlich valves/pigtail catheters good for? What is a heimlich valve?
Simple pneumothorax. Heimlich valve is a one-way valve that allows air out but not in.
What is a flail chest?
Segment of rib cage breaks off and becomes detached from chest wall
What are the three main purposes of a chest tube?
Evacuate air and fluid from pleural space. Re-establish negative pressure. Prevent mediastinal shift.
What do we do if there is an air leak?
Clamp starting from patient downward to find air leak, then either reinforce dressing, change tubing or drainage system.
What do we do if the chest tube becomes dislodged out of the patient?
Apply pressure, do three-way taped sterile gauze, over site, call doctor.
What do we do if the tubing becomes disconnected?
Put it under 2 cm of NS and get new tubing/drainage container.
How many RNs to remove CT
2
