Exam 2 - Pneumothorax Flashcards
Air in the pleural space leading to a lung collapse
pneumothorax
what are the 3 types of pneumothorax?
(1) open
(2) closed
(3) tension
causes of pneumothorax
(1) blunt chest trauma
(2) medical procedures
(3) underlying conditions, i.e., COPD
3 risk factors for pneumothorax are
(1) smoking
(2) age (20-30; 60-65)
(3) medical procedures
s/s of pneumothorax include
(1) respiratory discomfort
(2) chest pain
(3) SOB
(4) increased RR
(5) asymmetric lung expansion
(6) decreased or absent breath sounds
(7) tachycardia
(8) tracheal deviation
(9) JVD
(10) cyanosis
if the pneumothorax is mild, what is the treatment?
no treatment
if the pneumothorax is severe, the treatment is ____
thoracentesis and chest tube
____ is used to treat tension pneumothorax
immediate needle decompression with a large-bore needle
what is the treatment for hemothorax?
chest tube placement to remove blood in the pleural space
how do you diagnose pneumothorax?
(1) physical assessment
(2) chest x-ray
(3) CT scan
(4) ultrasound
the interventions for pneumothorax are
(1) insert chest tube
(2) needle thoracostomy
(3) pain management
connected by about 6 feet of tubing to a collection device placed below the chest
chest tube
____ is the minimum needed in the water seal to prevent air from flowing backward into the client
2cm
what are reasons for bubbling to STOP in the chest tube?
(1) all air is evacuated
(2) kinked or blocked chest tube
what is the main reason for excessive bubbling in the chest tube?
air leak
the water in the water-seal chamber column normally rises 2-4 inches during inhalation and falls during exhalation. this is called ___
tidaling
bubbling is normal during ____ or ___ b/c air in the chest is being expelled
forceful expiration; coughing
name at least 3 nursing priorities for chest tube management
(1) check hourly for sterility and patency of drainage system
(2) keep sterile gauze ready to place immediately if chest tube becomes dislodged
(3) keep padded clamps at bedside if drainage system is interrupted
(4) check water-seal chamber for unexpected bubbling
(5) notify surgeon if bubbling is continuous in water-seal chamber
(6) assess q1h respiratory distress after chest tube removal
the 3 pain management options are
(1) PCA
(2) ordered drugs
(3) opioid analgesics
purulent material in the pleural space
empyema
abnormal duct that develops between the bronchial tree and the pleura
bronchopleural fistula
do we want to see fluctuations in the chest tube chamber? why or why not?
Yes, b/c it reflects tiny bubbles from inhaling and ehaling
____ means there is still air coming into the chest system and lung is still working on re-expansion
fluctuation in the chest tube chamber
