Chpt 29 part 2

_______ tubes are used when fluid or air has collected in the pleural space.

• Endotracheal tubes
• Nasogastric tubes
• Foley catheters
• chest

Answer explanation

usually contains about 25 ml of fluid for lubrication during ventilation

What is true of a thoracentesis

• Procedure involves insertion of needle to remove air, fluid or instill medications

• patient positions should be upright; lean forward on bedside table;

• nurse should be in from to patient to observe them for resp. distress

• may remove 1-2 L of fluid

• CXR to monitor for pneumothorax

Match the following terms

• pneumothorax

• collapse lung due to air in the pleural space

• hemothorax

• blood and air in the pleural space

• hemopneumothorax

• blood in the pleural space

For which reasons would a chest tube be indicated?

• pneumothorax

• pleural effusion

• penetrating chest injury

• during chest surgery

• hemopneumothorax & hemothorax

Answer explanation

Normally a negative pressure exists in the pleural space but with a collapse lung, positive pressure enters and prevents lung expansion.

The ____ in the water-seal chamber shows that a chest tube is intact.

• crackling
• sizzling
• tidaling

• fizzing

What is the nursing care for a patient with chest tube and a drainage system?

• assess patient and the drainage system for leaks

• Must always keep drainage system upright and below the level of chest, never clamp chest tube

• stripping and milking the tubing should not be don

• sterile petroleum jelly and occlusive dressing is used to prevent air leakage.

• make sure each connection is securely taped to prevent a break in the system. Have 2 padded clamps at the bedside for accidental disconnection of tubing from the system

The idea behind the chest drainage system is to provide one way ​ (a)   mechanism to let air or fluid out of the​ (b)   space and prevent air from getting in. This is accomplished by using an underwater seal with the ​ (c)   end of the drainage tube submerged in 2 cm of sterile water.

• suction
• pleural
• distal

Fluid in the water seal chamber will ​ (a)   slightly until the lung is reexpanded and tidaling will occur in the tubing during ​ (b)   and expiration. When full reinflation occurs, tidaling ​ (c)   .

• bubble
• inspiration
• stops

At which points would you notify RN or HCP about the care of a chest drainage system

• The patient suddenly reports increasing dyspnea

• there is a change in the patient's status

• The drainage chamber is full and needs to be changed

If removal of air from around a collapsed lung is the goal, the chest tube is inserted into the upper anterior chest, in which intercostal space

• 3rd
• 5th
• 2nd- 4th