Thoracentesis

Question 1

2 things we want to do pre-procedure is to

Answer 1

get a chest x-ray and vital signs

Question 2

how do we position the patient for the procedure?

Answer 2

sitting up over the bedside table or have them sit backwards in the chair so we can get to the back (that’s where’s their gonna insert the needle)

Question 3

what if this patient is unable to sit up over the bedside table?

Answer 3

lie on unaffected side with the head of the bed at 45 degrees

Question 4

during the procedure, how must the patient be?

Answer 4

very still; no coughing or deep breathing (because we are inserting a needle in the pleural space… we could pop a lung)

Question 5

the fluid is being removed from the______

Answer 5

pleural space

Question 6

as the fluid is removed, the lungs should______

Answer 6

re-expand

Question 7

since you are removing fluid, the patient could go into a fluid volume______

Answer 7

deficit (can happen anytime you’re pulling off fluid) when you’re in a fluid volume deficit, heart rate goes up and the bp goes down.

Question 8

therefore, you should be checking the_____

Answer 8

vital signs (check VS whenever you’re pulling off fluids)

Question 9

what do we want to do post-procedure?

Answer 9

another chest x-ray to look for lung re-expansion

Question 10

After the needle is removed, what type of dressing do they put?

Answer 10

an occlusive dressing over the site

Question 11

what is the heimlich valve?

Answer 11

a device that acts like a teeny tiny chest tube. it promotes a 1 way valve that removes air from pleural space. (can be pinned to their gown so they can walk around)

Question 12

what is the heimlich valve used for?

Answer 12

small pneumothorax

Question 13

If this patient has a lot of crap in their pleural space that will take a while to drain, then what does this person get?

Answer 13

a chest tube