Chest Tubes
The primary purpose of a pleural chest tube is.
What is to remove air/fluid/blood to restore negative pressure and re‑expand the lung?
Two common signs of bacterial pneumonia.
What is a fever, a productive cough, and pleuritic chest pain/dyspnea?
Four phases of nociception.
What are transduction, transmission, perception, and modulation?
Define shock in one line.
Acute circulatory failure causes inadequate tissue perfusion and cellular hypoxia.
Equation for cardiac output and two determinants of SV.
CO = SV × HR; SV determinants: preload, afterload, contractility.
Where should the drainage system be kept relative to the chest?
What is always below chest level to prevent backflow?
Initial pneumonia management priority after cultures.
What is the start prescribed antibiotics and oxygen to target SpO₂?
Define tolerance vs. dependence.
Tolerance = need for a higher dose; dependence = withdrawal on abrupt stop.
Name two types of distributive shock.
What is septic and anaphylactic (also neurogenic)?
Pacemaker of the heart and normal rate.
SA node; ~60–100 bpm.
Normal water‑seal finding vs. sign of air leak.
What is tidaling (on inspiration/expiration)? Regular, continuous vigorous bubbling indicates an air leak.
ARDS hallmark regarding oxygenation.
What is severe hypoxemia refractory to conventional oxygen therapy?
One key nurse's responsibility before a procedure.
What is verified informed consent and pre‑procedure orders (e.g., NPO, meds)?
Early general sign of shock and a key lab marker.
What is tachycardia? Elevated lactate from anaerobic metabolism.
Define lung compliance.
Ease of lung expansion: low in fibrosis/ARDS, high in emphysema.
Two assessment points for safety.
What is the check dressing/site and all connections? Monitor drainage amount/colour and respiratory status.
Positioning intervention for refractory ARDS.
Prone positioning to improve oxygenation.
Essential monitoring during moderate sedation.
What is continuous airway/ventilation and oxygenation, VS, sedation level, and readiness for rescue?
Initial fluid choice and exception.
Isotonic crystalloids: normal salines & lactated Ringer'.
Primary drive for ventilation in healthy adults.
CO2 (via central chemoreceptors).
Action if tubing disconnects momentarily. Who can remove chest tubes?
Have the patient exhale/cough, cleanse and reconnect. If contaminated, place the end in sterile water and notify the provider per policy.
Who are Doctors & NP's
A patient with severe pneumonia has worsening hypoxemia on high-flow O₂. CXR shows bilateral infiltrates. BNP is normal, and bedside echo shows normal LV function.
What condition does this most strongly suggest?
What is ARDS (non-cardiogenic pulmonary edema) — bilateral opacities with refractory hypoxemia and no evidence of LV failure.
One item that must be documented post‑procedure.
What are the VS trends, meds given (dose/route/time), patient response, site assessment, and teaching provided?
First‑line for anaphylaxis, along with airway/oxygen.
What are Epinephrine IM promptly, plus fluids and adjuncts (antihistamines, steroids).
•Effect of left vs. right HF on circulation (one each).
Left HF: pulmonary congestion
Right HF: systemic venous congestion/edema.