Thoracic Chest Procedures Flashcards
Why are Thoracentesis Performed ?
To remove fluid or air from the pleural space
Throacentesis provide what ?
Analysis of lung fluids to determine cause of the effusion
Thoracentesis fluid may be sent for what ?
for culture or cancer cells
What should be done pre-procedure for Thoracentesis ?
- Check for signed informed consent (invasive procedure)
- Stop any anticoagulant medications
- Obtain baseline vital signs, O2 saturation & pain level
- Be sure that a chest x-ray has been performed
- Position client sitting on side of bed, feet supported, & leaning over bedside table
(if pt. can’t sit up, lie on unaffected side w/HOB @ 45º)
How should you position a client receiving a Thoracentesis ?
Sitting on edge of bed
feet supported
leaning over the bedside table
How should you position a client receiving a Thoracentesis, who can’t sit up ?
Lie on unaffected side With HOB at 45º
Where is the fluid, blood, or exudate being removed from in a Thoracentesis ?
Pleural space
During a Thoracentesis procedure, the client must be ?
Very still; no coughing or deep breaths
As the fluid is removed in a Thoracentesis, what should happen to the lung ?
It should re-expand
What should the nurse be assessing during a Thoracentesis procedure ?
Vital signs, oxygen sats and pain level
Compare to baseline
If a large amount of fluid is removed in a Thoracentesis, what should you watch for ?
Hypovolemia & shock
What should be done again post-Thoracentesis procedure ?
Another chest x-ray
What should the nurse check for post-Thoracentesis procedure ?
Check puncture site and dressing for bleeding
What other things should be done post-Thoracentesis procedure ?
- Monitor vital signs
- Listen to lungs for absent or reduced breath sounds on the affected side
- Monitor for subcutaneous emphysema, infection, and tension pneumothorax
What should you have a client do post-thoracentesis procedure ?
Turn, cough, and deep breathe
What has happened in a client who requires a chest tube ?
The lung has collapsed
If the chest tube is placed in the upper anterior chest (2nd intercostal space), what is it removing ?
Air
If the chest tube is placed laterally in the lower chest (8th or 9th intercostal space), then it is for ?
Drainage
_________ rises, and ________ settles ?
Air rises
Drainage settles
Can a client have both air & drainage in the lung ?
Yes!
What happens if a client has both air & drainage in the lung ?
They are Y-connected together and attached to a closed chest drainage unit (CDU)
How are chest tubes secured ?
It is sutured to the chest wall & with an airtight dressing applied around the chest tube exit site
- the chest tube is then connected to a closed chest drainage unit
- What is the purpose of the CDU ?
The purpose to restore the normal vacuum pressure in the pleural space.
(the CDU does this by removing all air and fluid in a closed one-way system until the problem is corrected)
What are the 3 chambers of the CDU ?
- ) Drainage collection chamber
- ) Water seal chamber
- ) Suction Control chamber
