Chest Tubes Overview and Usage

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Questions and Answers

What is the primary purpose of using chest tubes?

To re-establish negative pressure in the pleural space. (correct)

To provide supplemental oxygen.

To administer medications directly into the pleural cavity.

To facilitate lung expansion through positive pressure.

Where should a chest tube be placed for the removal of blood due to a hemothorax?

In the right lung only.

At the basal region of the lung. (correct)

In the left lung only.

At the apical region of the lung.

What is the exception to placing chest tubes after a total pneumonectomy?

The patient must not be intubated.

No pleural space remains for drainage. (correct)

The chest tube should be placed in a different location.

Only one tube should be placed in the remaining lung.

What should be your immediate action if the water seal of a chest tube breaks?

Clamp the chest tube, then cut it from the device. Signup and view all the answers

How many chest tubes are required for unilateral pneumohemothorax, and where should they be placed?

2 tubes at apical and basilar positions on the affected side. Signup and view all the answers

What is the recommended action if a chest tube comes out?

Cover it with vaseline gauze, dry sterile dressing and tape on 3 sides. Signup and view all the answers

In routine care, when is it acceptable to clamp a chest tube?

In an emergency situation. Signup and view all the answers

Which of the following statements is NOT true about the use of chest tubes?

They always have to be inserted bilaterally. Signup and view all the answers

What is the ideal method for re-establishing a water seal after it has broken?

Place the tube under sterile water and then unclamp it. Signup and view all the answers

What is the first action you should take when arriving at a scene where a person is unresponsive with no pulse?

Place a backboard Signup and view all the answers

Which of the following best describes the action that must be taken if continuous bubbling is observed in the water seal of a chest tube?

Find the leak and tape it until it stops Signup and view all the answers

In congenital heart defects, what color is associated with trouble defects that shunt blood from right to left?

Cyanotic, blue Signup and view all the answers

What should you do if the suction control chamber shows intermittent bubbling?

Turn up the suction on the wall Signup and view all the answers

How long can you clamp a tube without a doctor's order?

No more than 15 seconds Signup and view all the answers

What is the normal length of hospital stay for a patient with a no-trouble congenital heart defect?

24-36 hours Signup and view all the answers

What action should be taken if the water seal is broken?

Clamp it immediately Signup and view all the answers

Which of the following indicates a trouble congenital heart defect?

Requires immediate surgery Signup and view all the answers

In which circumstance is intermittent bubbling in the suction control chamber acceptable?

When the suction pressure is low Signup and view all the answers

What color are patients with a no-trouble defect typically associated with?

Pink Signup and view all the answers

Study Notes

Chest Tubes

Chest tubes re-establish negative pressure in the pleural space.
They are used for lobectomy and wedge resections, pneumothorax, hemothorax and pneumohemothorax.
Apical tubes are placed high for air.
Basilar tubes are placed low for blood.
Two chest tubes are generally required for unilateral pneumohemothorax, one apical and one basilar, on the affected side.
Two chest tubes are generally required for bilateral pneumothorax, one apical on each side.
Two chest tubes are generally required following chest surgery, one apical and one basilar, on the side of the surgery.
No chest tube is required following a pneumonectomy because there is no pleural space.
Chest tubes should only be clamped in an emergency.
A water seal chest tube is preferable to a dry seal chest tube.
If the collection bottle is kicked over, it can be sat back up and the patient encouraged to take deep breaths.
If the water seal breaks, the chest tube should be clamped, cut away from the broken device and submerged under sterile water before being unclamped.
- This re-establishes the water seal.
- It is better to submerge the tube under water than to clamp it as it allows contents to exit the tube.
If the chest tube comes out, the hole should be covered with a gloved hand immediately. This should be followed by a vaseline gauze dressing, a dry sterile dressing and tape.
Intermittent bubbling in the water seal is good and should be documented.
Continuous bubbling in the water seal is bad and indicates a leak. The leak should be located and taped until it stops leaking.
Intermittent bubbling in the suction control chamber is bad and indicates the suction is not high enough. The suction on the wall should be turned up.
Continuous bubbling in the suction control chamber is good and should be documented.
Never clamp a chest tube longer than 15 seconds without a doctor's order.

Congenital Heart Defects

Every congenital heart defect is either trouble or no trouble.
All congenital heart defects that begin with “T” are trouble, except for left ventricular hyperplastic syndrome.
Trouble defects shunt blood from right to left and are cyanotic. These defects require surgery, are associated with delayed growth, decreased life expectancy and require more time in the hospital and involve pediatric cardiologists.
No-trouble defects shunt blood from left to right and are acyanotic. These defects do not require surgery, are associated with normal growth, normal life expectancy and only require 24-36 hours in the hospital and involve pediatricians or nurse practitioners.

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Description

This quiz covers the essential aspects of chest tubes, including their purpose in re-establishing negative pressure in the pleural space and their application in various medical conditions such as pneumothorax and hemothorax. Learn about the placement of apical and basilar tubes, as well as the protocol for clamping and managing the water seal. Test your knowledge on the considerations required in different clinical scenarios involving chest tubes.