Lab 3 chest tubes

Question 1

what is a chylothorax

Answer 1

when lymphatic fluid leaks into the plural space

Question 2

what is empyema

Answer 2

when pus from an infection leaks into the plural space

Question 3

what is the difference between transudate and exudate fluid build up

Answer 3

Transudate is when there is a change in hydrostatic pressure that causes fluid to build up and exudate is when there is fluid excreted from something that builds up in the pleural space

Question 4

what is a wedge resection

Answer 4

When a small piece of the lung is removed from the body

Question 5

what is a lobectomy

Answer 5

when an entire lobe is removed from the lung

Question 6

what is a pneumonectomy

Answer 6

when an entire lung is removed

Question 7

when accessing a chest tube where do you start your assessment

Answer 7

start at the insertion site and work your way down to the drainage container

Question 8

What are the 9 steps for accessing a chest tube

Answer 8

1. Drsg is it dry and occlusive
2. Tubing no dependent loops and not clogged
3. Drainage note amount and type
4. Bubbling is there bubbling in the water chamber
5. Tidalling this is normal
6. Water level in the seal chamber
7. Safety ie clamps-are there some at the bedside
8. Suction is it turned on or are they just on gravity
9. Bellow-is the suction at the right level
   Don’t Take Dirty Bubbles Through Water, Safety Sinks Below

Question 9

what is splinting

Answer 9

if a postoperative patient has to cough they can place a pillow over the incision and squeeze or hug the pillow close to the chest wall while coughing

Question 10

At what point would an increase or decrease in fluid start to be worrying

Answer 10

if there is a sudden increase or decrease of fluid greater than 100 mL/h that is when it would start to be concerning

Question 11

what is a thoracostomy

Answer 11

Creation of a surgical opening in the chest

Question 12

what is a thoracotomy

Answer 12

an incision into the chest cavity

Question 13

what is pleurodesis

Answer 13

a procedure that gets rid of the pleural space to prevent recurrent pleural effusions

Question 14

what is a thoracoscopy

Answer 14

the insertion of an endoscope to examine the inside of the chest cavity

Question 15

what is decortication

Answer 15

removal of an abnormal fibrous membrane that has grown on the visceral pleura

Question 16

what 5 steps would you take if a chest tube did get accidently pulled out

Answer 16

1. Don clean gloves
2. Placed gloved hand over insertion site
3. Call for help
4. apply 3 sided dressing
5. Call doctor

Question 17

what 5 steps would you take if the chest tube became disconnected

Answer 17

1. Have patient exhale and cough
2. Clamp chest tubes cross wise
3. disinfect ends of tube with chlorhexidine or alcohol and reconnect
4. Tape connections
5. Unclamp

Question 18

when would a Pigtail catheter be indicated for a patient

Answer 18

If there is a smaller amount of drainage or air only and since they are smaller they are more comfortable for the patient

Question 19

the diameter of the chest tube selected depends on what?

Answer 19

-size of the patient
-type of drainage
-and the expected length of time they will have the chest tube

Question 20

usually what percentage of the pleural space has to be taken up by air or fluid for the patient to start being symptomatic

Answer 20

if less than 10% is taken up by fluid or air the patient will usually not show respiratory systems and the body will be able to reabsorb the fluid or air

Question 21

what does the mediastinum contain

Answer 21

-Heart
-Thymus gland
-Esophagus
-Trachea

Question 22

If you want to access chest tube drainage where do you look

Answer 22

In the chest tube and not in the collection chamber since the collection chamber can have drainage that is days old

Question 23

do you tape chest tube connections vertically or with spiral taping

Answer 23

always tape chest tube connections vertically

Question 24

What is the most common indication of a pleur-x drain

Answer 24

Mainly used for intermittent long term drainage or recurrent pleural effusions

Question 25

what is the main indication for a Peggy drain

Answer 25

usually used for spontaneous pneumothorax

Question 26

what is the collection capacity of a P-Eggy drain

Answer 26

can hold up to 100 mL

Question 27

what would a pig tail drain be used for?

Answer 27

serves the same purpose as a large bore chest tube but is more comfortable for the patient and is for smaller amount of drainage