Positioning & Chest Tubes Flashcards
Trendelenburg
Feet elevated higher than head
LEFT LATERAL: Suspected air embolism
= will cause air to rise to the RA.
NOT FOR:
- Most neuro conditions = increases ICP, pulls spinal fluid
- Ascites (risk for dyspnea)
Lumbar puncture
Side-lying with the head, back, and knees flexed
= maintains spine in horizontal position
Chest tube placement
Arm raised above head on the affected side w/ HOB at 30-45
Femoral artery cardiac catheterization
Supine OR Reverse Trendelenburg
= reduces the risk for hemorrhage/pressure on artery
AVOID HIP FLEXION
Post-liver biopsy
Right-lying for a min. of 2 hours, then supine for 12-14 hours
= applies pressure + splint the puncture site
Semi-fowler
- Liver cirrhosis
- Ascites
-Restraints
-Post-op
*mostly to prevent aspiration and improve oxygenation
Tripod position
To facilitate lung expansion
- Often seen in COPD/asthma exacerbation
Orthopneic
Pt is sitting upright, leaning forward onto bedside table to support body weight
- Promote lung expansion
Prone
Post-lower limb amputation
= prevents hip contracture
ARDS
= improve oxygenation
Sims position
Enema administration
Laparoscopic abdominal procedure
=alleviate referred shoulder pain
Purpose of Chest tubes
Re-establish negative pressure in the pleural space
Pneumothorax
Puncture in lungs, allowing air to enter pleural space
Hemothorax
Blood entering pleural space
Apical vs Basilar Chest tube
The location of the chest tubes
APICAL
- Higher up in the chest
- Removes air
- Expect to bubble + no liquid drainage
BASILAR
- Bottom of the lungs
- Removes blood/liquids
- Expect to drain liquid + no bubbling
How many + where is chest tube placement for:
- Unilateral pneumothorax
- Bilateral pneumothorax
- Post-op chest surgery
Unilateral pneumothorax
- 2; apical + basilar
Bilateral pneumothorax
- 2; one per side
Post-op chest surgery (assume unilateral)
- 2; apical + basilar
