All About the Atrium
True or False: Chest tube insertion can be performed at the bedside on MedSurg
True
Bonus Question- where can you easily get all the supplies required for a CT insertion?
Thoracic Vent red valve is deflected downward. Patient has lungs sounds equal bilaterally. You anticipate the physician will place this order.
What is clamp chest tube, Chest xray to determine if chest tube can be removed?
Bonus: How do you clamp a Thoracic Vent?
In order to collect accurate intake and output for a chest tube, this must be marked on the Atrium every shift.
What is the drainage level with date/time?
Appropriate for oxygen needs of 6-10 liters
What is simple face mask?
Name this tubing
What is an End Title CO2 cannula?
Standard suction for a patient with a Chest Tube is -20cm H2O. Wall suction needs to be at this level to maintain the suction that is selected on the Atrium.
What is 80-100mm/hg?
Patient is transported to radiology for a chest x-ray. The transporter needs to keep the Atrium in this location to maintain function.
What is maintain drainage system below chest level?
Demonstrate how you would position the patient and the Atrium for transport.
You assist the physician to insert the chest tube. Name the documentation that is required in Soarian
What is Time Out (Universal Protocol) & Bedside Procedure (MD Assist)?
Appropriate oxygen therapy for patients requiring oxygen up to 6 liters
What is nasal cannula?
Bonus: Humidification is recommended when administering greater than how many liters through nasal cannula?
Green port in patient room is for Oxygen. Purpose of the yellow port.
What is Medical Air used for delivering SVN treatments?
usually for patient with COPD, C02 retainers
Constant bubbling in water-seal chamber indicates air leak. In order to assess for the location of the leak, you will progressively clamp the tube starting at this location.
What is the chest tube insertion site?
Chest tube management requires frequent monitoring throughout the shift. Demonstrate an assessment of Chest tube.
Extra documentation required in Respiratory Assessment when patient is on a Bipap
What is alarm check and assessment of skin integrity under the mask?
Mask that can be used for patient requiring oxygen anywhere from 1 liter to 15 + liters/flush
What is the OxyMask?
Placed by a physician for a patient with a simple Pneumothorax
What is Thoracic Vent (ThoraVent)?
Normal pressure changes in pleural space during breathing will display like this on the Atrium
What is the water chamber may have tidaling of the white ball 5-10cm?
Patient lung shows that it has re-expanded on today's chest x-ray and you can hear lung sounds are equal bilaterally. The physician puts in an order to remove the chest tube. The person responsible for removing the chest tube.
Who is the physician?
Bonus: demonstrate the supplies needed on hand for the physician to use during removal
Nursing intervention required when a patient is placed on oxygen due to low saturation who was previously on room air
What is notify the physician and obtain an order for oxygen?
Oxygen is a medication. Anytime a patient needs to be placed on oxygen is a change in condition. We must inform the MD to obtain an order and the parameters for use of the oxygen
Appropriate for patients requiring over 10 liters of oxygen
What is a Non-re-breather (NRB) mask?
Bonus Points: What do you need to do to prep the NRB prior to placing on patient?
Patients with a Chest tube will have pain with breathing, so they may take shallow breaths. Nurse needs to encourage them to use this device every hour to maintain lung expansion.
What is an Incentive Spirometer?
(also to Cough & Deep Breath)
Atrium is almost full. MedSurg stocks new Atriums in the supply rooms, but you need to do something prior to removing it from the bin.
What is charge the item to the patient?
ICU stocks them in the chest tube cart or requests from warehouse. Patient will be charged when cart restocked or warehouse needs pt label.
Bonus: Demonstrate replacement of the Atrium
Supplies needed if a chest tube dressing needs to be changed.
Elastoplast tape, scissors, petroleum gauze, sterile 4x4s, sterile split drainage gauze (Drain Sponges)
Bonus: Demonstrate a dressing change
End title C02 monitoring every 4 hours may be ordered for patients with COPD, post-op, or patients on this type of medication.
What is a PCA pump?
Documentation will be scheduled in Soarian and link to a respiratory assessment
The normal range for End Title C02 (measurement of exhaled CO2 in the breath)
What is 35-45 mmHg?
Thoracic Vent is placed by the ER physician. Name the two supplies that you will ask the ER nurse to bring with the patient to ensure we are able to properly manage the Thoracic Vent.
What is the occlusion plug and the thoracic Vent suction tubing?