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A drainage system where a tube is used to drain air and fluid from the pleural space
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Chest tube returns negative or positive pressure to the lungs?
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CH 30 - M IV
Testing subject Chest tube drainage
| Question | Answer |
|---|---|
| A drainage system where a tube is used to drain air and fluid from the pleural space | chest-tube drainage |
| Chest tube returns negative or positive pressure to the lungs? | negative |
| chest tube drainage permits___of collapse lung | re-expansion |
| chest tube drainage: used for patients with three types of conditions, name them. | Hemothorax, pneumothorax, pleural effusion |
| when inserting a chest tube, the procedure is performed in the operating room only: true or false | false: can be done at the bedside also |
| Chest-tube drainage: to remove air from the lungs, where is the tube inserted? where is it inserted for fluid? | second to fourth intercostal space; eighth or ninth intercostal space |
| Chest-tube drainage: what type of dressing is applied? | occlusive/air tight sterile dressing |
| name the three compartments of a chest tube drainage unit: from left to right. | Suction control, water seal, drainage collection |
| Chest-tube drainage: gentle bubbling is normal in which chamber? | WET Suction control chamber |
| does dry suction chamber have bubbling? | no |
| Chest-tube drainage: which chamber should have tidalling? Fluid rises when and fluid falls when? | water seal chamber; rises = inspiration; falls = expiration |
| Chest-tube drainage: the chamber in which the chest tube from the client connects to the system is called: | drainage collection |
| Nurse observes continuous bubbling in the waters seal chamber. what does this indicate? | Air leak in the chest tube system |
| a chest tube system was just connected to the patient. The nurse observes bubbles in the water sealed chamber. She points out that there must be an air leak. Was she correct? | No: air bubbles are seen in the water seal chamber when it if first connected to pt. It should stop after a short time |
| The nurse notes that there is no bubbling in the water seal. What can this indicate. | Lungs expanded; tube obstructed; a dependent loop exists; or suction is not properly working |
| The nurse observes that 2 cm of water in the water seal chamber was blue. What should the nurse do? | Nothing, this is normal according to Mrs. M (double check your notes i'm not sure) |
| Collection chamber intervetions: Notify physician if the drainage is greater or less than 100mL/hr? | greater than 100 mL/hr (Mrs. M's hand out says 200 mL and her hand out is from an older NCLEX-PN book) |
| Collection chamber intervetions: what other times should you contact the physician regarding drainage? | drainage becomes bright red or suddenly increases |
| Collection chamber intervetions: mark the chest tube drainage how many hours. | 1-4hrs |
| How many cm of water pressure is kept in the water seal? | 2cm...greater than 2 cm causes air and fluid to go into the drainage system |
| If a client has pneumothorax, what is an expected observation in the water seal? | INTERMITTENT bubbling |
| what two occassions is bubbling in the water seal normal? | pt has a pneumothorax; when tube is first connected |
| Nurse is observing two clients each w/ their own chest tube system. Pt. A has vigorous bubbling in the suction control chamber, pt B has gentle bubbling. Which is abnormal? | Pt. A: indicates leak, report to physician |
| Review on chambers: Under normal conditions which chambers have bubbling, tidaling etc. | Suction control: GENTLE bubbling; Water seal: Tidaling; Drainage: none |
| After chest tubes have been inserted, what is done to confirm placement? | chest x-ray |
| After chest tube procedure the nurse monitors respiratory status, auscultate ___ sounds, encourage ___ and ___ ____. | lung; coughing; deep breathing |
| Keep drainage system below the lvl of the ____, keep tubes free of ___. | chest; kinks |
| Chest tube drainage: what nursing intervention can be done to promote drainage and ventilation. | change position frequently |
| Chest tube drainage: what two things are kept at the bedside at all times? | A clamp and a sterile occlusive dressing |
| Chest tube drainage: if the system cracks or breaks what must the nurse do? | insert chest tube into a bottle of sterile water |
| A chest tube was accidentally pulled out from the client's chest, what must a nurse do immediately? | pinched the skin opening together, occlusive dressing, overlap with pieces of tape, notify registered nurse or physician immediately |
| a client has recovered after a chest tube drainage system was in place. When the tube was removed what must you tell the client to do? What intervention follow? | take a deep breath and hold it; apply dry sterile dressing, petroleum goddess dressing, or Telfa dressing. |
| What three things must the client do when the chest tube is removed? | Deep breath, exhale, bear down (Valslva's maneuver) |
Created by:
Jgar2007