Show:
Drainage
Assessment
Management
Sounds or Sensations
Time Out
100
Pleural Effusion - to drain fluids Hemothorax - to drain blood Pneumothorax - to drain air
What are the type of situations where chest tubes may be used?
100
1. Vitals 2. Respiratory effort and sats 3. Lung sounds 4. Pain
What are the types of assessment data you should obtain prior to inserting a chest tube?
100
The dressing around the insertion site - ensure it is dry, intact and occlusive.
What is the most important part of the drainage system to monitor?
100
A crunchy or spongy sensation, or like popping under the fingers.
What is Subcutaneous Emphysema or Crepitus?
100
Placed 1.5 - 2.5 inches from the insertion site and about 1 inch apart, going in opposite directions when changing the drainage system
What are Kelly clamps?
200
The technique that should be used when changing the occlusive dressing
What is sterile technique?
200
Assess and observe for pain, administer analgesics
What is an important step for nursing prior to chest tube insertion and removal?
200
The order that the physician will place to be completed immediately after insertion and a few hours after removal of a chest tube
What is a chest xray?
200
What is likely occuring if respiratory distress is present and lung sounds are absent or one sided
What is dislodgement or occlusion of the tube or the lung is not re-inflating
200
This is what can occur with prolonged clamping of the chest tube.
What is Pnuemothorax?
300
A practice which can cause dangerous negative pressure build-up in the pleural space, and bruising and trauma to the lung tissue
What is milking or stripping the tubing?
300
The things you should assess after removal of a chest tube and application of the occlusive dressing
What are lung sounds, RR, O2 sats, and pain
300
The frequency that dressings should be changed
What is every 24 hours?
300
A visual indication that the drainage system is functioning properly
What is the presence of bubbling in the water-seal chamber?
300
The person who removes the chest tube
Who is the physician?
400
An indication of fresh bleeding which requires notification to physician STAT
What is drainage in excess of 100mL/hr OR becomes bright red drainage
400
A type of pneumothorax in which the trachea is noted to deviate to one side
What is Tension Pneumothorax?
400
A system that prevents air from re-entering the chest once it has escaped.
What is a "closed water-seal" system?
400
Constant bubbling in the water seal chamber
What is an indication of an air leak
400
Where you should place the chest tube if it becomes disconnected from the drain system (to create a water seal).
What is a bottle of Normal Saline?
500
When drainage suddenly decreases and the water seal chamber is no longer tidaling
What is an indication that the chest tube is occluded?
500
A type of rib fracture in which multiple ribs are broken off and "floating" unattached to the rib cage
What is a flail chest?
500
The chamber that prevents suction pressure from being applied to the pleural cavity
What is the suction control chamber?
500
Gentle rising and falling of the water level in the water seal chamber with respirations
What is Tidaling?
500
Apply an occlusive dressing immediately and call the Physician
What should you do if the chest tube becomes dislodged?