Chest tubes, and Surgery, and Edema Oh My!

Tubes of the chest

100

This is the space that a chest tube is inserted into

What is the pleural space

200

This chamber on the chest tube device receives fluid and air from the pleural space.

What is the collection chamber

300

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

400

You should immediately do this when a chest tube is dislodged

Cover the site with a sterile occlusive dressing, reinforced by several 4x4s

500

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

Around the lobe

100

Give me one example of a pulmonary hygiene intervention

IS

TCDB

Splinting

Adaptive huffing

200

This treatment option is most common with Lung Cancer

What is a pneumonectomy.

300

This is the post-op risk associated with patients with low hemoglobin

Hypoxia

400

Adequate pain control post-surgery prevents these two things

What is post-op respiratory failure and Atelectasis

500

Name the 4 thoracic surgeries.

Segmental

Wedge

Lobectomy

pneumonectomy

Rising pressure

100

Is there an apparent cause of Primary Pulmonary Arterial Hypertension?

No

200

Pulmonary Hypertension can eventually lead to this cardiac condition

Right-sided HF (Cor Pulmonale)

300

This is the normal Pulmonary Artery Pressure

24/12

400

These 4 areas may become enlarged or distended because of the pulmonary HTN

Jugular vein

Abdomen

Liver

BLE

500

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

Breath Taking

100

Sudden pink, frothy sputum can indicate this

Flash pulmonary edema

200

What is one major underlying cause of Pulmonary edema

L Sided HF

300

Give me at least two treatments for Flash Pulmonary Edema

Supplemental Oxygen, IV diuretics, Possibly mechanical ventilation/intubation

400

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

500

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

Catch your breath

100

What is the purpose of pleural fluid?

To lubricate the parietal and visceral pleura

200

What is empyema?

A collection of purulent fluid in the pleural space

300

What is pulmonary vascular resistance?

Resistance to blood flow in the pulmonary vasculature.

400

Upon percussion, how would a pleural effusion sound?

Dull

500

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