Equipment and Set Up
This functions as a one-way valve, allowing gas to escape but not air to return, which helps maintain negative pressure and expand the lung.
What is the water seal?
Prior to chest tube insertion, the nurse should obtain an order for this.
What is pain management?
The rhythmic rise and fall of fluid in the water seal chamber with breathing.
What is tidaling?
The action to take when you enter the patient's room and see that the chest tube has fallen out of their chest.
What is "cover the wound with the petroleum gauze that is kept at the bedside for this type of emergency"?
A gloved hand will also work until you can get the three-sided occlusive dressing on and call for help.
This is the type of fluid used to fill the pleura-vac drainage system during set up.
What is sterile water?
The patient is placed in this position to open the intercostal spaces during chest tube insertion.
What is the semi-Fowlers position with ipsilateral (same side) arm raised?
The amount of bloody drainage per hour that warrants immediate surgeon notification.
What is greater than 1500mLs initially or continued blood loss of more than 200mL/hr for 2-4 hours.
The level that the drainage system should be kept at while transporting the patient or assisting them to the bathroom.
What is "upright" and "below the patient's chest"?
These two items must be immediately available at the bedside of any patient with a chest tube.
What are petroleum gauze and clamps for emergency sealing/clamping?
This type of anesthesia is used at the insertion site before chest tube placement.
What is local anesthesia (lidocaine)?
Continuous bubbling in the water seal chamber indicates this problem.
What is an air leak?
The nurse should assess the chest tube insertion site for this finding- a crackling sensation under the skin- which indicates subcutaneous emphysema.
What is crepitus?
The suction control chamber is filled with water to this depth in a standard Pleur-evac system.
What is 20 cm?
This type of anesthesia is used at the insertion site before chest tube placement.
What is local anesthesia (lidocaine)?
This is why you need two suction units at the head of the patient's bed.
Suction for drainage system and suction for airway compromise.
These are the only two BRIEF reasons to clamp the chest tube.
What is "accidental disconnection" and/or "when changing the drainage unit"?
Do not clamp the chest tube during transport.