Respiratory Flashcards
Normal Function of the Lung
Oxygen enters our lungs as part of the air that we breathe. It goes to the blood vessels deep in our lungs and then on to all parts of our body. As our body uses oxygen, it makes a waste product called carbon dioxide. We get rid of carbon dioxide when we breathe out.
This provides oxygen for metabolism of the tissues
Removes carbon dioxide, the waste product of metabolism
Secondary functions include sense of smell, producing speech, maintaining acid base balance, maintain water levels and maintain heat balance
Effective gas exchange depends on the distribution of gas and blood in all portions of the lungs.
Tracheal suctioning
Don’t suction before drawing ABG’s- will deplete the O2
Assist client into upright position Hyperoxygente Client Insert cath without suction applied Once inserted, apply suction intermittently while rotating and withdrawing catheter Hyperoxygenate listen to breath sounds Document
Thoracentesis
Pre-procdure:
CXR and baseline vials
Sitting up leaning over bed side table or lying on unaffected side with HOB at 45
Procedure:
VERY STILL, no coughing or deep breaths
Fluid/exudate is removed from pleural space
Lung re expands
Since fluid is being removed, they can go into a fluid volume deficit. Check BP and pulse.
Post procedure
CXR
D- Dimer
A blood test that measures clot formation and lysis that results from the degradation of fibrin
Helps diagnosis DVT, PE, or stroke. Also assists in diagnosing DIC and monitor effectiveness of treatment
Chest Tube Location implications
If the chest tube is placed in the upper anterior chest, it is to remove air
If the chest tube is placed laterally in the lower chest, then it is for exudate/fluid
A client is able to have both that are Y connected and attaached to a closed chest drainage unit (CDU)
Chest Tube Insertion and Purpose of the CDU
A chest tube is sutured to the chest wall and an air tight dressing is applied around the chest tube exit site and then connected to the CDU.
The CDU is to restore the normal vacumn pressure in the pleural space. It does this by removing all air and fluid in a closed one way system until the problem is corrected.
CDU drainage collection chamber
The Chest tube connects to a 6 foot connection tube that leads to the drainage collection chamber. when it is full, REPLACE.
CDU water seal chamber
The purpose of the water seal is to promote one way flow out of the pleural space which will prevent air from moving back up the system and into the chest.
The drainage chamber and water seal chamber are connected by a strawlike
CDU water seal chamber
The purpose of the water seal is to promote one way flow out of the pleural space which will prevent air from moving back up the system and into the chest.
The drainage chamber and water seal chamber are connected by a channel that allows the drainage to remain in the first chamber and the air to go down into the water of the water seal chamber. The water seal contains 2cm of water which acts as a valve preventing oneway flow.
You may see bubbling when the client coughs, sneezes or exhales and a slight rise when they breath. Tidaling is normal and when it has stopped it means the lung has re-expanded. The Air exits the water seal chamber and enters the suction control.
CDU Suction control Chamber
If the client needs suction to remove air and fluid, this chamber control the amount of pressure applied.
Sterile water is placed in this chamber up to the 20 cm line. Turn on wall vacuum until you have slow gentle continuous bubbling
Management of CDU
Assessment:
Assess Dressing - Must be kept tight and clean
Listen to lungs bilaterally
Monitor pulse ox and report below 90%
Record Drainage every hour for 24 hours and then every 8
NOtify PHC of 100ml of drainage or greater in one hour or if there is a change of color to bright red.
Deep breath, cough and use incentive spirometer
Watch for fever, WBC up and drainage = infection
Daily CXR
Maintaing CDU
Keep below the chest
if too high, Drainage will shwoop back in. promote gravity drip.
Keep tubing straight and free of kinks and dependent loops
Tape connections. MuST BE A CLOSED ASS SYSTEM
Monitor water levels
Wanna see tidaling with resps
Trouble shooting
Keep another sterile connector at bed side if disconnected - reconnect as fast as u can
If it falls over
Do what you can to protect the water seal
HAve the client cough and deep breath to prevent air from pleural space
no water = collapse lung
If it is pulled out Occlusive dressing taped down 3 sides
Chest Tube Removal
Have client take a deep breath and bear down and place an occlusive petroleum dressing over the site
When is bubbling normal?
Chest tube connected to suction - gentle and slow. with coughing, sneezing deep breathing and exhaling - intermittent
