Respiratory Flashcards
When doing a thoracentesis, what if the client cant sit up. how should you have them positioned?
lie on unaffected side with HOB at 45 degree
What has happened that the client needs a chest tube?
the lung has collapsed.
if the chest tube is placed in the upper anterior chest (2nd intercoastal space) then it is for removal of ___.
air
if the chest is placed laterally in the lower (8th or 9th intercoastal space) then it is for ____.
drainage
can the client have a chest tube that it for air and drainage?
yes. they are y-connected together and attached to a closed drainage unit (CDU)
the CDU is to restore the normal vacuum pressure in the pleural space. does this by removing all air and fluid in the closed one way system until the problem is corrected
if the CDU drainage collection chamber fills up, what should you do?
get new CDU. it hold 2,000 ml. rarely have to change
if a dry suction is used, water is not used to regulate the pressure therefore _____.
has NO bubbling. a dial is used to set the desired negative pressure. then once again increasing the vacuum wall suction will not increase the pressure.
when the CDU, notify the physician of ___ ml of drainage or greater in the 1st hr, and if there is a change in color to ____.
100ml
bright red
with CDU, do you want to see tidaling (fluctuations) ?
yes with respirations
fluctuations will stop when the lung has re-expanded, if there is a kink/clot in tubing, or a dependent loop is present in the system.
what if the chest tube is accidently pulled out?
re-establish the water-seal!!!
sterile vaseline gauze taped down on 3 sides. otherwise, every time they take a breath, they will pull air into pleural space.
when is bubbling normal with CDU?
chest tube connected to suction–gentle continuous bubbling is expected in the suction chamber
if a client with a pneumothorax is coughing, sneezing or just taking a deep breath and exhaling, you may see intermittent bubbling in the water seal chamber
as long as there is intermittent bubbling, the client needs the chest tube bc air is still leaking out of the pleural space.
when is bubbling in CDU a problem?
if there is continuous bubbling in the water seal chamber, then you have an air leak in the system,
never clamp a chest tube without an order!! it could lead to tension pneumothorax
what will show up on chest xray for pneumothorax or hemothorax?
air or blood
tension pneumothorax
trauma,peep, clamping a chest tube, or taping an open pneumothorax on all 4 sides without an air valve.
this is an emergencyy!
if a pnuemothorax is present and the client has a chest tube, what type of bubbling would be expected in the water seal chamber?
intermittent bubbling
