Respiratory Flashcards
(74 cards)
Chest tubes nurse alert
- Ensure that the tubing is patent and free of
dependent loops (drainage accumulating in dependent
loops obstructs chest drainage into the collecting
system and increases pressure within the lung. - Asses for air leaks in the system as indicated by
constant bubbling in the water seal chamber. - Assess for patent system: note the fluctuations or
tidaling of water in the water seal chamber. - Do not turn off the suction control stopcock OFF
when transporting the patient (to prevent tension
pneumothorax). - Dislodgement of chest tube/drainage system.
At the junction of chest tube/drainage system
immerse the end of the chest tube into a glass of water
to maintain water seal.
at the insertion site- instruct patient to take a deep
breath and hold it until site is sealed. - Immediately cover with Vaseline gauze and sterile
4×4 dressing and tape in place.
Chest tube documentation
- Collection chamber: amount and appearance of
drainage - Water seal chamber: water level, bubbling, and
fluctuations of tidaling - Suction chamber: water level
- Monitor chest tube drainage every 2 hours or more
frequently in the immediate post operative period.
Chest tube trouble shooting
Sudden experiences of trouble breathing
1. Check for occlusion/kinking of the tube and integrity
of the line.
2. Ensure that suction control stopcock is in ON
position
Constant bubbling in the water seal chamber
Assess for air leaks in the system. To assess location
of a leak, intermittently occlude for a moment (< 1
minute) the chest tube or drainage tubing beginning at
the insertion site of progressing to the chest drainage
unit.
Tubing obstruction
Scan length of tubes for signs of mechanical
obstruction
2. If clots exists call MD, milking and stripping of chest
tubes is only performed with a specific physician order.
Theophylline side effects
Tachycardia, anxiety, headache, cramps, nausea and
vomiting
Theophylline, drink to avoid
Soda, coffee, tea, chocolate due to the caffeine, as it
increases CNS effect.
Spiriva handi-haler (tiotropium bromide) sides effects
Spiriva is a bronchodilator, maintenance treatment for
COPD. Most common side effect - dry mouth.
Other side effects: constipation and urinary retention
Barrel chest is commonly seen in condition called.
COPD
Client with emphysema
Instruct purse- lip breathing
Part of tracheostomy tube removed while cleaning.
Inner cannula
Mechanical ventilator alarming due to increased pressure
Check for tubing for kinks
Signs and symptoms of fat emboli
Petechiae in chest and abdomen, shortness of breath,
chest pain,
hypotension, decreased Pa)2 and increased PCO2.
Protamine Sulfate indication.
Reverses the anticoagulant effect of Heparin.
Protamine sulfate is administered intravenously.
Side effects of Protamine Sulfate
Hypertension or hypotension and pulmonary
hypertension
bradycardia, dyspnea
Caution with Protamine
Receiving Protamine-containing insulin
Vasectomy men, allergy to fish
Streptomycin indication and possible adverse reaction to watch:
Anti-PTB (pulmonary tuberculosis),
watch for auditory nerve damage, (8th cranial nerve)
TB patient being transported for Chest X-ray
Apply mask on patient when transporting.
Mechanical ventilation to observe other than ventilator
alarm.
Kinks and condensation of water in the tubing.
Patient is taking INH, what to monitor?
Monitor intake and output due to urinary retention.
Medication to decreases bronchial secretions
Atropine Sulfate
Acute pulmonary edema medicine to avoid
Coumadin
Assessment with patient taking narcotics.
Respiratory rate (Bradypnea)
Tracheostomy care what to intervene
Tracheostomy care what to intervene - removal of old
trachea ties
Side effects of Aminophylline
Gastric irritation, nausea, arrhythmias
Asthma prophylaxis, exercise induced-asthma
Sodium Intal (discontinue use during acute attack)
