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Terms in this set (15)
When assessing chest tube dressing, it must be _______&_______
tight & intact
During assessment, report if pulse ox is <____
Record drainage Q__H for 24hrs, then Q__H
Q1H for 24hours
Notify MD if drainage ___ml or greater in 1st hr, and if __________
100ml or greater
and change in color to bright red
watch chest x-rays _____ for _____
daily for re-expansion
only _______can transport client w/ chest tube to radiolody for x-ray
nurses!! (if stable, LPN nurses can too)
water level in suction control chamber should be _____cm
water level in water seal chamber should be
1)it is OK for ______bubbling in water seal chamber
2)it is OK for ______ _______ bubbling in suction control chamber
1)intermittent (during coughs, exhale, deep breath, sneeze)
2) continuous gentle
if NO tidaling (flactuations) with respirations in water seal chamber, it means
lung has re-expanded,
kinks/clot in tubing,
what happens if tubing becomes disconnected?
1) another sterile connector at the bedside (asap)
or if not present
2) RECONNECT the connection
what if chest tube pulled out of pt?
1)sterile vaseline gauze, tape down 3 sides
(if not present at bedside)2) slap hand down on pt's chest and call someone to bring gauze!
what happens is CONTINUOUS bubbling in water seal chamber?
first check all connection sites for air leak,
then call MD!
can you clamp a chest tube w/o a physician's order?
(COULD LEAD TO TENSION PNEUMO)
chest tube removal:
have pt valsalva (take a deep breath and hold or humm) & place occlusive petroleum gauze over site
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