Pulmonary Flashcards
What should a properly functioning chest tube drainage system look like?
- continuous gentle bubbling in suction control chamber
- water level on water seal chamber should fluctuate when tube is inserted and when pt inhales/exhales
- NEVER CHANGE the suction without a dr. order
- connection btw chest tube and drainage should be taped
- add water to chamber as it evaporates
When should a chest tube be clamped?
- When changing the drainage device
- when looking for a leak
Simple rules for pt on a ventilator
- never turn a ventilator alarm to off
- always assess the pt first and THEN the ventilator
First signs of ARDS?
- increasing RR
- THEN labored breathing, retractions, air hunger, and cyanosis
How to clean a stoma after a laryngectomy?
With a washcloth only. No alcohol (bc its drying and irritating). Protect it from water.
Soaps, cotton swabs, or tissues should be avoided because their particles may enter and obstruct the airway. A non–oil-based ointment applied to the skin around the stoma helps to prevent cracking.
How can you ensure that a tracheostomy tie is not too tight?
-you should be able to slide 2 fingers under it.
What does a positive TB test look like?
- non HIV client: induration of >10mm
- HIV pt: induration of >5mm
describe an arterial ulcer?
pale deep base and are surrounded by tissue that is cool with trophic changes such as dry skin and loss of hair. Arterial ulcers are caused by tissue ischemia from inadequate arterial supply of oxygen and nutrients
describe a venous stasis (AKA vascular)
a dark red base and is surrounded by brown skin with local edema. This type of ulcer is caused by the accumulation of waste products of metabolism that are not cleared, as a result of venous congestion.
Where should the bubbling be in chest tube drainage system?
- the suction control chamber, NOT in the water seal chamber.
- although some bubbling can be seen in the water seal chamber (ie. when the pt coughs)
How long do pt’s generally need to take isoniazide?
-6 months
where should an endotracheal tube be marked?
at the level where it touches the incisor tooth or the nares
How much drainage should be expected in a chest tube drainage system?
70-100 is excessive. 50 or below is expected
When removing a chest tube what should you tell the pt to do?
bear down
Carbon monoxide levels: which result in…
Carbon monoxide levels between 11% and 20% result in flushing, headache, decreased visual activity, decreased cerebral functioning, and slight breathlessness; levels of 21% to 40% result in nausea, vomiting, dizziness, tinnitus, vertigo, confusion, drowsiness, pale to reddish-purple skin, tachycardia; levels of 41% to 60% result in seizure and coma; and levels higher than 60% result in death.
