Tubes of the chest
This is the space that a chest tube is inserted into
What is the pleural space
Give me one example of a pulmonary hygiene intervention
IS
TCDB
Splinting
Adaptive huffing
Is there an apparent cause of Primary Pulmonary Arterial Hypertension?
No
Sudden pink, frothy sputum can indicate this
Flash pulmonary edema
What is the purpose of pleural fluid?
This chamber on the chest tube device receives fluid and air from the pleural space.
What is the collection chamber
What is a pneumonectomy.
Pulmonary Hypertension can eventually lead to this cardiac condition
Right-sided HF (Cor Pulmonale)
What is one major underlying cause of Pulmonary edema
L Sided HF
What is empyema?
A collection of purulent fluid in the pleural space
Give me one "can" and one "cannot" for transporting a chest tube.
Can- disconnect from suction and on to water seal
- maintain the chest tube below the heart.
Cannot- clamp the chest tube
Hypoxia
This is the normal Pulmonary Artery Pressure
24/12
Give me at least two treatments for Flash Pulmonary Edema
Supplemental Oxygen, IV diuretics, Possibly mechanical ventilation/intubation
What is pulmonary vascular resistance?
Resistance to blood flow in the pulmonary vasculature.
You should immediately do this when a chest tube is dislodged
Cover the site with a sterile occlusive dressing, reinforced by several 4x4s
Adequate pain control post-surgery prevents these two things
What is post-op respiratory failure and Atelectasis
These 4 areas may become enlarged or distended because of the pulmonary HTN
Jugular vein
Abdomen
Liver
BLE
How does flash pulmonary edema differ from a pleural effusion
Pleural effusion is a buildup of fluid in the pleura while flash pulmonary edema is fluid buildup in the interstitial and alveolar space
Upon percussion, how would a pleural effusion sound?
Dull
These 4 signs indicate that a chest tube could be removed
What are
Patient status improved
Decreased drainage- >100mL/hr
Air leak resolved
X-ray shows lung expansion
Name the 4 thoracic surgeries.
Segmental
Wedge
Lobectomy
pneumonectomy
How is Pulmonary Artery Hypertension Diagnosed?
Mean pulmonary artery pressures above 25 mmHg at rest or 30 mmHg with exercise,
Right-sided cardiac catheterization, EKG, imaging, PFTs
You have a 62y.o. female pt with a history of L-sided CHF and chronic kidney disease. She presents with sudden severe SOB, chest tightness, and does not tolerate laying supine. BP 190/110, O2 88%, bilateral lung crackles, leg edema and ascites.
What is the likely diagnosis and what are two key interventions?
Flash Pulmonary edema
Rapid BP control, Oxygenation, fluid removal
A 45 y.o. male comes into the emergency room from a MVA. Sever l-sided chest pain, Difficulty breathing, and l-sided diminished breath sounds. BP is 100/70, HR122, O2 86%. The provider placed a chest tube at bedside for a pneumothorax.
What are two expected outcomes?
Improvement of Oxygenation
Re-expansion of the left lung