Terms in this set (38)
where is a mediastinal chest tube placed?
-in mediastum, below sternum
where does a pleural chest tube originate?
the lungs - pleural space
when are mediastinal chest tubes placed?
during open heart surgery to drain blood from thoracic cavity
-so doesnt cause cardiac tamponade
when are pleural chest tubes placed?
to drain blood, fluid, pus, escaped air from lung
what is the mediastinum?
surrounds esophagus, heart, trachea, and great vessels
what is the plural cavity?
-visceral pleura - lines the lungs
-parietal pleura - lines interior chest wall
-pleural space - b/w viscera and parietal pleura - lubricating fluid
what is a pneumothorax?
collapsed lung caused by collection of air in pleural space
what is a pneumothorax caused by?
loss of intrapleural negative pressure
what will cause a pneumorthorax?
-insertion of central IV cath
where are chest tubes placed in patients with pneumothorax?
-upper intercostal spaces (since air rises)
what is a tension pneumothorax?
compression of the thoracic components
what is a s/s of a tension pneumothorax?
mediastinal shift of trachea towards good lung
what is a pleural effusion?
collection of fluid in pleural space
what is empyema?
collection of pus in the pleural space
where is the chest tube placed with pleural effusion and empyema?
lower intercostal spaces - collects fluid that drops by gravity
what is a hemothorax?
collapsed lung caused by collection of blood b/w visceral and parietal pleurae
what causes a hemothorax?
what are s/s of hemothorax?
s/s of hypovolemia and hypovolemic shock
what are s/s of pneumothorax?
what is a dry chest tube system?
-suction control chamber is dry
-most commonly used (not at kaiser)
what is a water-seal chest tube system?
-suction control chamber filled with fluid (like kaiser's)
what determines the amount of suction on a dry chest tube system?
-the suction control dial in chamber
-this is regardless of the amount of source suction (from wall)
what determines the amount of suction on a water-seal chest tube system?
-determined by the height of the column of H2O in the suction control chamber
-water must be bubbling to work
what do you set chest tube suction at?
- -10, -15, -20, -30, -40
what chest tube drainage is too much and should be reported to MD?
more than 100ml/hr
when can chest tubes be clamped?
when changing container or or when isolating an air leak
what is tidaling?
the normal rise and fall with respirations in the water-seal chamber
-expiration = falls
what will happen in the chest tube container if there's an air leak?
-bubbling will happen in air leak chamber
what is an expected reason for an air leak?
chest tube just placed for pneumothorax
what is an unexpected reason for an air leak?
-hole in chest tube tubing
-disconnection of chest tube from pt
how do you isolate an air leak?
-clamp tube near insertion site
if air leak stops after clamping, where is leak? what to do?
-in body or at dressing
if air leak doesn't stop after clamping, where is the leak? what do you do?
-in distal tubing
-continue to move clamp down until leak stops
how long can you clamp a chest tube?
no more than 10sec
what do you do if the chest tube is accidentally dislodged from the insertion site?
cover site with clean gauze and ask someone to notify MD ASAP
where should chest tube container be placed?
hang from bed or tape on the floor
what should be given to the MD prior to chest tube removal?
-suture removal kit
where is the chest tube container discarded?
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