Respiratory Flashcards
What should you do if a chest tube becomes dislodged?
apply pressure over the insertion site w/ a dressing that is tented on one side to allow escape of air
What should you do if a chest tube becomes disconnected from the drainage system?
cut the contaminated tip off of the tubing using a sterile scissors and immerse the end of the chest tube in 2 cm sterile water until system can be re-established
Where are chest tubes placed on a patient and why are they used?
they’re placed in the pleural space to drain air and/or lymphatic fluid and/or blood so that the lung can re-expand (the drainage system consists of 1 or more chest tubes)
Where do you place the collection container for a PT w/ a chest tube? What is it for?
place it below the PT’s chest and a water seal is used to keep air from entering the chest (this is where the drainage drains to)
nursing responsibilities r/t chest tube PTs
- Look out for for constant bubbling in the water-seal chamber (if continuous, indicates an air leak in the drainage system or in the PT. INTERMITTENT BUBBLING IS GOOD/MATCHES PT’S BREATHING). No bubbling is also bad.
- Monitor that the tubing doesn’t become dislodged or disconnected.
- Monitor amt of water in chamber (should always be at least 2 cm)
- Monitor drainage chamber (if “only” pneumothorax, you may not see any drainage)
- Monitor skin around site
what is the suction usually set at for adults on a chest tube
20 cm
what is the suction usually set at for children on a chest tube
15 cm
how does tube “milking” work
squeeze release move, squeeze release move. Always go proximal to distal. DO NOT STRIP
In what position should you place a postop PT after a new tracheostomy is placed?
Semi-Fowlers. Turn the PT’s head to one side until consciousness is regained.
This position facilitates respiration, promotes drainage, prevents edema, and prevents strain on the suture line.
how often should tracheostomy care be completed?
every 8 hrs or as needed
what is an indication for needing to perform tracheostomy care?
-secretions (excessive or tried)
which PTs are at risk for hospital-acquired pneumonia?
- depressed immune function
- chronic health problems
- risk for aspiration (e.g. NG tube)
- defense mechanisms
- poor oral care, mechanical ventilation
what is pneumothorax
lung collapse caused by accumulation of air in the pleural cavity; indications include pleuritic pain, tachypnea, diminished breath sounds; treatment includes chest tubes
what are early symptoms of oxygen toxicity in a PT receiving O2 per face mask
nonproductive cough, nasal congestion, sore throat, substernal discomfort or pain, GI upset, dyspnea
what are late symptoms of oxygen toxicity in a PT receiving O2 per face mask
decreased vital capacity, incr dyspnea, crackles, hypoxemia; atelectasis or structural damage to the lungs, along w/ pulmonary edema and hemorrhage and stiffness of lung tissue can occur (known as adult respiratory distress syndrome (ARDS)
