Lab 3 chest tubes Flashcards
what is a chylothorax
when lymphatic fluid leaks into the plural space
what is empyema
when pus from an infection leaks into the plural space
what is the difference between transudate and exudate fluid build up
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
what is a wedge resection
When a small piece of the lung is removed from the body
what is a lobectomy
when an entire lobe is removed from the lung
what is a pneumonectomy
when an entire lung is removed
when accessing a chest tube where do you start your assessment
start at the insertion site and work your way down to the drainage container
What are the 9 steps for accessing a chest tube
- Drsg is it dry and occlusive
- Tubing no dependent loops and not clogged
- Drainage note amount and type
- Bubbling is there bubbling in the water chamber
- Tidalling this is normal
- Water level in the seal chamber
- Safety ie clamps-are there some at the bedside
- Suction is it turned on or are they just on gravity
- Bellow-is the suction at the right level
Don’t Take Dirty Bubbles Through Water, Safety Sinks Below
what is splinting
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
At what point would an increase or decrease in fluid start to be worrying
if there is a sudden increase or decrease of fluid greater than 100 mL/h that is when it would start to be concerning
what is a thoracostomy
Creation of a surgical opening in the chest
what is a thoracotomy
an incision into the chest cavity
what is pleurodesis
a procedure that gets rid of the pleural space to prevent recurrent pleural effusions
what is a thoracoscopy
the insertion of an endoscope to examine the inside of the chest cavity
what is decortication
removal of an abnormal fibrous membrane that has grown on the visceral pleura
what 5 steps would you take if a chest tube did get accidently pulled out
- Don clean gloves
- Placed gloved hand over insertion site
- Call for help
- apply 3 sided dressing
- Call doctor
what 5 steps would you take if the chest tube became disconnected
- Have patient exhale and cough
- Clamp chest tubes cross wise
- disinfect ends of tube with chlorhexidine or alcohol and reconnect
- Tape connections
- Unclamp
when would a Pigtail catheter be indicated for a patient
If there is a smaller amount of drainage or air only and since they are smaller they are more comfortable for the patient
the diameter of the chest tube selected depends on what?
-size of the patient
-type of drainage
-and the expected length of time they will have the chest tube
usually what percentage of the pleural space has to be taken up by air or fluid for the patient to start being symptomatic
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
what does the mediastinum contain
-Heart
-Thymus gland
-Esophagus
-Trachea
If you want to access chest tube drainage where do you look
In the chest tube and not in the collection chamber since the collection chamber can have drainage that is days old
do you tape chest tube connections vertically or with spiral taping
always tape chest tube connections vertically
What is the most common indication of a pleur-x drain
Mainly used for intermittent long term drainage or recurrent pleural effusions
what is the main indication for a Peggy drain
usually used for spontaneous pneumothorax
what is the collection capacity of a P-Eggy drain
can hold up to 100 mL
what would a pig tail drain be used for?
serves the same purpose as a large bore chest tube but is more comfortable for the patient and is for smaller amount of drainage
