Problems of Oxygenation - Part 3 Flashcards
Fluctuation of fluid that occurs during respiration
Tidaling
If tidaling is not occurring, what does this indicate?
That there is a block in the system (chest tube)
When checking bubbling in the water compartment of the chest tube, what is normal, what is not?
Occasional bubbling is normal, continuous indicates air leak
What is the purpose of milking the tubing?
Used to dislodge fragments of blood clots or lung tissue that are blocking the tubing
Why should milking the tubing not be done regularly?
Because it increases intrapleural and intrapulmonary pressures
Although clamping the drainage tube of a chest tube is often contraindicated, when is it appropriate?
Appropraite when assessing the readiness for the removal of the chest tube and when changing the drainage system
It is best to clamp the drainage tube during _______.
expiration
Clamping the drainage tube:
- if the tubing becomes unattached, it is best to try to _______ or immerse in bottle of sterile _______ to reestablish seal.
reattach
saline
Removing the chest tube:
- _______ decision
- Not to be removed if > ___-____ mL of drainage daily
- the sooner the tube is removed, the faster the improvement in post-operative _____
- removal can be moderately painful so, __-_______
- One should have equipment to apply ________ dressing over the site immediately to ensure ________ does not occur
physician decision (although a trained nurse can remove it) 50-70mL pain pre-medicate occlusive; pneumothorax
Collection of fluid in the pleural space
pleural effusion
Pleural effusion occuring in non-inflammatory connditions - CHF, chronic liver or renal disease
Transudative effusion (hydrothorax)
Pleural effusion that occurs in an area of inflammation with pulmonary malignancies, pulmonary infections, pulmonary embolization and GI disease (pancreatitis)
Exudative effusion
A pleural effusion containing pus
Empyema
Complication of empyema, where there is a fibrous fusion of the visceral and parietal pleura
Fibrothorax
Procedure done when there is too much fluid in the pleural space. This allows pleural fluid analysis to be performed in lab to figure out the cause of fluid accumulation around one or both of the lungs.
Thoracentesis
Describe thoracentesis.
Use a large needle (with a 60mL syringe) to pull out fluid
What is another name for thoracentesis.
Pleural tap
Abnormal accumulation of fluid in the alveoli and interstitial spaces of the lungs.
Pulmonary edema
What is the most common cause of pulmonary edema?
Left sided congestive heart failure
Pulmonary HTN: can be primary, or secondary.
Secondary results from a complication of a ______ or ________ disorder.
respirator, cardiac
Enlargement of the right side of the heart secondary to respiratory system disorders./
Cor pulmonale
The most common cause of Cor pulmonary is what?
May also result from this.
COPD
may also result from pulmonary HTN
IF pulmonary HTN goes unchecked, this cardiac disorder will occur.
CHF
If we cannot fix cor pulmonale, the patient will go into _______.
arrest
Chronic inflammatory disorder of the airway causing hyper-responsiveness and broncho-constriction.
Asthma
What are the obstructive pulmonary diseases we learn about in class?
Asthma, COPD, CF
Asthma is a result of environmental effects on the airway, ______, ______ and _______ agents trigger airway inflammation and airway narrowing.
allergens, chemicals, infectious agents