Chest Tube Management
Q: What is the purpose of a chest tube?
A: To drain air/fluid and reestablish negative intrapleural pressure.
Q: What is the purpose of a tracheostomy tube?
A: Bypass airway obstruction, secretion removal, long-term ventilation.
Q: What are two risk factors for laryngeal cancer?
A: Smoking and alcohol use.
Q: What causes upper airway obstruction?
A: Foreign bodies, swelling, infection, trauma.
Q: What is pleuritis vs. pleural effusion?
A: Pleuritis: inflammation. Effusion: fluid in pleura.
Q: What are the three main parts of a chest drainage system?
A: Suction control, water seal, collection chamber.
Q: What is a cuffed vs. fenestrated trach tube?
A: Cuffed: sealed airway. Fenestrated: allows speech.
Q: What are early signs of laryngeal cancer?
A: Hoarseness, sore throat, lump in neck.
Q: What is angioedema?
A: Rapid, painless swelling of face/tongue; may block airway.
Q: How is a patient positioned for thoracentesis?
A: Sitting upright, leaning forward.
Q: What does continuous bubbling in the water seal mean?
A: Indicates an air leak.
Q: Why monitor cuff pressure and what’s the range?
A: Avoid airway injury; 20-25 cm H₂O.
Q: What is the difference between partial and total laryngectomy?
A: Partial: voice preserved. Total: permanent stoma.
Q: What are signs of anaphylaxis?
A: Stridor, wheezing, hypotension, urticaria.
Q: What causes pleural effusion?
A: CHF, infection, cancer, PE, liver/kidney disease.
Q: What should you do if the chest tube becomes disconnected?
A: Submerge in sterile water, set up a new system.
Q: When should a patient be suctioned?
A: Audible secretions, low O₂, gurgling, increased effort.
Q: What are nursing implications after total laryngectomy?
A: Stoma care, suctioning, alternate communication.
Q: What emergency actions are needed for airway obstruction?
A: Upright position, oxygen, epinephrine, intubation.
Q: What are types of thoracic surgery?
A: Lobectomy, pneumonectomy, wedge resection.
Q: When can a chest tube be removed?
A: Lung re-expanded, minimal drainage, no air leaks.
Q: What abnormal signs indicate need for suction?
A: Cyanosis, wheezing, stridor, accessory muscle use.
Q: How can nurses help with post-laryngectomy communication?
A: Writing boards, electrolarynx, speech therapy.
Q: What meds help manage airway swelling?
A: Epinephrine, diphenhydramine, corticosteroids.
Q: Why is pain management critical post-thoracic surgery?
A: Pain limits breathing and increases risk of pneumonia.