Assessment
Name a reason a patient would have a chest tube
Air
Fluid
Surgial
What does a continous bubbling mean?
Your patient has an air leak
True or false: when a chest tube goes to water seal that will help determine if the chest tube is ready to be removed
Your chest tube falls out..
What do you do?Cover up the chest tube site and call the MD
watch patient's status!false. Tidaling is normal and indicates the circuit is clean and working
What is
1. Patient site
2. Atrium: drainage, bubbling, tidaling, wall suction and suction setting
How can you troubleshoot a continuous air leak?
clamp from the atrium to the patient to determine where the leak is located
How much drainage will a patient have in a day before a chest tube is removed?
Typically <100-150mL
The physican orders a culture.. explain how this is done
Clean chest tube site where cultures are obtained and attached a clean syringe and pull back to collect fluid
When might tidaling not be present?
when a pneumothorax is resolved
Your chest tube assessment reveals you have had 250mL of drainage over 4 hours, should you call the provider?
Yes, drainage greater then 200mL over 4 hours should be reported
What does the orange beveal indicate when it is fully expanded?
The suction is hooked up and working within the system
DAILY DOUBLE: This question will receive double the points if answered correctly.
What supplies should be at the bedside when a chest tube is going to be removed?
Tape, gauze, and vaseline gauze
There is no water in the water seal chamber.. explain how to add more saline
Take needle and sterile saline and insert through cushion hole on the back of the atrium
Explain how tidaling will look when the patient is not on a ventilator (how will the ball move)
as the patient breathes in, the ball will move up and as the patient exhales it will go down
How often should your chest tube be assessed and charted on?
every 4 hours
What is a typical setting for the suction to be set up as (not the wall suction)?
-20
Name a way you would expect the physician to ask the patient to breathe while the tube is being removed by the provider
Breath in and exhale out while the chest tube is being removed
Hold breath and chest tube is removedMy patient has been on water seal for 2 hours and starts developing shortness of breath and 02 sats are dropping.. what orders might you anticipate when you call the provider
hook the patient back up to wall suction and receive an order for a chest xray