Chest Tubes Flashcards
A chest tube goes by many different names, including _______________ tube and chest drain. The plastic tube enters the side of the patient’s chest to remove _____________ from around the heart and lungs.
chest drainage; blood, air, or fluid
The lung contains two tissue layers called _______________ that contain fluid that assists the lungs with helping patients breathe. Conditions and diseases—such as pleural effusion, emphysema, tumors, heart failure, hemothorax, infection, and pneumothorax—may cause ____________________-
pleura; blood, air, or additional fluid to gather in the pleural space.
The chest tube helps the patient breathe better by _________________ the lungs. Without the use of a chest tube, patients who have certain conditions and diseases may have their lungs________________ if the pressure becomes too great in their chest.
expanding; collapse
The chest tube should contain approximately 6 feet of tubing that connects to a _______________-device located several feet below the patient’s chest. Instruct the patient not to rest the body on the tubing. The nurse should take this time to check the patient’s tubing for ______________ in the tubing line. The nurse should also ____________ the tubing connections to prevent air from leaking out of the tube.
collection; twists and kinks; tape
The drainage system has a _________ seal that operates as a _____________valve. The nurse must add the required amount of _____________ into the patient’s separate water chamber while ensuring the end of the patient’s tubing ____________ in the fluid.
water; one way; saline; remains
Add ______________ to the chest drainage system if necessary, but remember that the amount of ________ depends on the saline solution’s depth.
suctioning; suctioning
The respiratory status of the patient requires frequent assessment to maintain the patient’s health. Nurses should also make note of ______________ breathing sounds near the side of the patient’s chest tube.
decreased
To maintain the care of the chest tube, nurses should encourage the patient to perform _________________ or _________________
deep-breathing exercises or coughing.
The complications that patients may experience as a result of the chest tube include _______________ and _____________- in the arm or leg.
infection and blood clots
The blood clots can travel to the patient’s lungs, causing breathing problems and chest pain, which can be life-threatening. The tube can also poke through organs close to the lungs. The chest tube can also move out of place as the patient turns or moves.
accumulation of blood within the pleural cavity - what are characteristic symptoms
hemothorax
The symptoms of a hemothorax include chest pain and difficulty breathing, while the clinical signs include reduced breath sounds on the affected side and a rapid heart rate.
a tube inserted into the pleural space of the lungs to remove air or fluid and to help the lung re-expand OR it is a tube placed in the mediastinum space to help drain blood or fluid from around the heart after cardiac surgery
chest tube
Reasons for chest tube insertion
Cardiovascular surgery
Pneumothorax: air enters into the pleural space and causes the lung to collapse (trauma to the chest or spontaneous)
Pleural Effusion: fluid in the pleural space
Types of Pleural Effusions:
Hemothorax: blood enters in the pleural space and causes lung to collapse (trauma to the chest, disease TB, blood clotting issue)
Empyema (infection in the pleural space)
Chylothorax (lymphatic fluid in pleural space),
_________________- chest tubes are usually placed after cardiac surgery to help drain blood from the pericardial space (placed under the sternum) which prevents fluid from compressing the heart which can lead to cardiac tamponade.
Mediastinal
a small space that surrounds the lungs that contains a small amount of serous fluid. This small space is surrounded by the parietal and visceral pleurae. These two layers ___________-over each other which creates a negative pressure.
pleural space; glide.
Therefore, if air or extra fluid enters into the pleural space the lungs are severely affected and can collapse.
infection in the pleural space
empyema
lymphatic fluid in the pleural space
Chylothorax
Two types of chest tube drainage systems
Wet Suction (water seal suction)
Dry Suction
basic Difference between wet suction and dry suction chest drainage systems
In wet, there is a suction control chamber with water in it
In dry, there is no suction control chamber with water in it. Rather it uses a suction monitor bellow
suction regulated by the height of water in the suction control chamber when connected to wall suction
Which type of suction is this ?
Wet Suction
some have stop-cocks to help regulate the amount of bubbling (you will hear bubbling while it’s working….water evaporates overtime so you will have to re-add it)…physician determines the suction level (usually -20cmH2O).
This chest drainage system has no water column to control suction but uses a suction monitor bellow (looks like an orange accordion) that balances the wall suction and you can adjust water suction pressure using the rotary suction dial on the side of the system.
Which type of suction is this ?
Dry suction
It allows for higher suction pressure levels, has no bubbling sounds, and water does not evaporate from it as with other systems.
It allows for higher suction pressure levels, has no bubbling sounds, and water does not evaporate from it as with other systems.
Which type of suction is this ?
Dry suction
Nursing Management of a Chest Tube:
Drainage system itself: we want to
keep system below patient’s chest
Nursing Management of a Chest Tube: Tubing: what do we want to make sure
Keep it free from kinks and make sure it is draining freely (not clots or stagnate fluid) and that all connections are sealed
Nursing Management of Drainage Collection Chamber
Monitor drainage (color, amount…..should drain no more than 100 cc/hr and record routinely)
