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Questions and Answers
What is the primary difference between an open pneumothorax and a closed pneumothorax?
What is the primary difference between an open pneumothorax and a closed pneumothorax?
- An open pneumothorax causes total lung collapse, while a closed pneumothorax causes partial lung collapse.
- An open pneumothorax involves air entering the pleural space through a hole in the lung tissue, while a closed pneumothorax involves air entering through a hole in the chest wall.
- An open pneumothorax involves air entering the pleural space through a hole in the chest wall, while a closed pneumothorax involves air entering through a hole in the lung tissue. (correct)
- An open pneumothorax requires surgical intervention, while a closed pneumothorax resolves spontaneously.
In a tension pneumothorax, compression of the heart and vasculature can lead to what potentially life-threatening condition?
In a tension pneumothorax, compression of the heart and vasculature can lead to what potentially life-threatening condition?
- Hypotension (correct)
- Bradycardia
- Tachycardia
- Hypertension
Why is a three-sided occlusive dressing used for an open chest wound related to a pneumothorax?
Why is a three-sided occlusive dressing used for an open chest wound related to a pneumothorax?
- To absorb any blood or fluid leaking from the wound.
- To completely seal the wound and prevent any air movement in or out of the pleural space.
- To allow air to enter the pleural space during inhalation and prevent it from escaping during exhalation.
- To prevent air from entering the pleural space during inhalation but allow air to escape during exhalation. (correct)
Which of the following clinical findings would a nurse expect to assess in a client with a pneumothorax?
Which of the following clinical findings would a nurse expect to assess in a client with a pneumothorax?
What is the purpose of the water seal chamber in a chest tube drainage system?
What is the purpose of the water seal chamber in a chest tube drainage system?
What does continuous bubbling in the water seal chamber of a chest tube drainage system typically indicate?
What does continuous bubbling in the water seal chamber of a chest tube drainage system typically indicate?
What is 'tidaling' in the context of a chest tube drainage system, and what does it indicate?
What is 'tidaling' in the context of a chest tube drainage system, and what does it indicate?
What should be the nurse's immediate action if a chest tube is accidentally dislodged from a patient?
What should be the nurse's immediate action if a chest tube is accidentally dislodged from a patient?
If a patient with a chest tube suddenly exhibits bright red drainage exceeding 100 mL/hr, what action should the nurse prioritize?
If a patient with a chest tube suddenly exhibits bright red drainage exceeding 100 mL/hr, what action should the nurse prioritize?
Where should the chest tube drainage collection device be positioned in relation to the patient's chest?
Where should the chest tube drainage collection device be positioned in relation to the patient's chest?
In a patient with a chest tube, what does a tracheal shift away from the affected side indicate?
In a patient with a chest tube, what does a tracheal shift away from the affected side indicate?
Which intervention is most important for a nurse to perform before a chest tube is removed?
Which intervention is most important for a nurse to perform before a chest tube is removed?
What should the nurse assess in a post-operative patient who underwent the central line placement for the presence of closed pneumothorax?
What should the nurse assess in a post-operative patient who underwent the central line placement for the presence of closed pneumothorax?
A patient with a hemothorax is likely to have which symptom?
A patient with a hemothorax is likely to have which symptom?
When caring for a patient with a chest tube, which action should nurse avoid?
When caring for a patient with a chest tube, which action should nurse avoid?
What is the clinical manifestation of a client with suspected tension pneumothorax?
What is the clinical manifestation of a client with suspected tension pneumothorax?
What is the rationale behind positioning a patient in Fowler's position when managing a pneumothorax?
What is the rationale behind positioning a patient in Fowler's position when managing a pneumothorax?
When auscultating the lungs of a patient with a pneumothorax, what finding is most expected?
When auscultating the lungs of a patient with a pneumothorax, what finding is most expected?
If a patient has a chest tube connected to a water seal drainage system, what should be monitored?
If a patient has a chest tube connected to a water seal drainage system, what should be monitored?
What is the expected outcome to look for in the water seal drainage system related to the chest tube?
What is the expected outcome to look for in the water seal drainage system related to the chest tube?
Air accumulation in the intrapleural space can cause what manifestations?
Air accumulation in the intrapleural space can cause what manifestations?
What should the nurse do if a patient displays restlessness and dyspnea?
What should the nurse do if a patient displays restlessness and dyspnea?
The client had a chest tube inserted 2 hours ago. What should the nurse document?
The client had a chest tube inserted 2 hours ago. What should the nurse document?
What is a key component of managing a chest tube to promote effective drainage and prevent complications?
What is a key component of managing a chest tube to promote effective drainage and prevent complications?
For a patient with chest trauma, what is the finding that could be presented at the site of trauma?
For a patient with chest trauma, what is the finding that could be presented at the site of trauma?
What does decreased tactile vocal fremitus suggest?
What does decreased tactile vocal fremitus suggest?
Which symptom requires the three sided occlusive dressing?
Which symptom requires the three sided occlusive dressing?
Which is the best position to prevent aspiration?
Which is the best position to prevent aspiration?
What is the main action of the negative pressure in the pleural space?
What is the main action of the negative pressure in the pleural space?
To prepare the chest tube to allow air escape, which procedure should you follow?
To prepare the chest tube to allow air escape, which procedure should you follow?
What could result in a tracheal shift to the unaffected side?
What could result in a tracheal shift to the unaffected side?
What can be expected with chest pain?
What can be expected with chest pain?
Collapsed lung manifests by what common symptom?
Collapsed lung manifests by what common symptom?
Which is a sign of hypoxia?
Which is a sign of hypoxia?
If the drainage exceeds 100 mL/hr, what action is needed?
If the drainage exceeds 100 mL/hr, what action is needed?
Appropriate X-ray should be done when?
Appropriate X-ray should be done when?
Which statement is true regarding chest tube removal?
Which statement is true regarding chest tube removal?
What should be applied over the chest tube insertion site.
What should be applied over the chest tube insertion site.
Flashcards
Pneumothorax
Pneumothorax
Air enters the pleural space, causing lung collapse.
Open Pneumothorax
Open Pneumothorax
Air enters pleural space through chest wall hole.
Closed Pneumothorax
Closed Pneumothorax
Air enters pleural space through lung tissue hole.
Hemothorax
Hemothorax
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Tension Pneumothorax
Tension Pneumothorax
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Tracheal Deviation
Tracheal Deviation
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Collapsed Lung Signs
Collapsed Lung Signs
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Pneumothorax intervention
Pneumothorax intervention
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Fowler's Position
Fowler's Position
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Chest Tube Purpose
Chest Tube Purpose
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Collection Chamber Function
Collection Chamber Function
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Water Seal Chamber Purpose
Water Seal Chamber Purpose
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Tidaling
Tidaling
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Bubbling
Bubbling
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Suction Chamber Function
Suction Chamber Function
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Wet Seal Chamber
Wet Seal Chamber
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Dry Seal Chamber
Dry Seal Chamber
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Chest Tube Device Placement
Chest Tube Device Placement
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Unplanned Chest-Tube Removal
Unplanned Chest-Tube Removal
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Study Notes
- Pneumothorax involves air entering the pleural space, leading to partial or total lung collapse
Types of Pneumothorax
- Open pneumothorax occurs when air enters through a chest wall hole, such as a gunshot wound
- Closed pneumothorax happens when air enters through a lung tissue hole, potentially post-surgery or central line placement
- Hemothorax is blood accumulation in the pleural space
Tension Pneumothorax
- Tension pneumothorax is a closed pneumothorax where trapped air in the intrapleural space causes collapse of affected and possibly unaffected lungs
- This results in trachea shift to the unaffected side, heart and vasculature compression, and subsequent hypotension
Clinical Features of Collapsed Lung
- Hypoxia is a key feature
- Progressive dyspnea, restlessness, anxiety, and cyanosis may manifest
- Chest pain, coupled with hypotension and tachycardia, is common
- Low O2 saturation presents in a collapsed lung
- Diagnosis can be supported with a Chest X-ray for stable clients only
Assessment Findings for Suspected Tension Pneumothorax
- Hyperresonance to percussion (low-pitched)
- Diminished breath sounds on affected side
- Decreased tactile vocal fremitus (no air movement/vibration felt on patient's back during speech)
- Hypotension presence
Nursing Interventions
- Apply a three-sided occlusive dressing over the chest wound, which allows air to exit upon breathing out, but seals upon breathing in
- Place the patient in Fowler's position
- Connect a chest tube to a water seal drainage system
- To allow air to escape and prevent reentry
- To reestablish negative pleural air pressure, facilitating lung expansion
Drainage Collection System
- Collection chamber measures and collects fluid
- Water seal chamber allows air to exit through a one-way valve
- Tidaling (fluid movement with breathing) indicates proper function
- Bubbling indicates an air leak
Suction Chamber
- Applies negative pressure to the system
- Continuous bubbling in a wet seal chamber
- No bubbling in a dry seal chamber
Other interventions
- Administer pain medications
- Ensure that the chest tube has no kinks or leaks, and no dependent loops in the tubing
- Drainage exceeding 100 mL/hr or sudden bright red drainage should be reported to a healthcare provider
- The collection device should be positioned below the insertion site
- Reinforce occlusive dressing if drainage is present
- Ensure appropriate X-ray is taken after changes in chest tube status or after tube removal
Unplanned Chest-Tube Removal
- If unplanned chest tube removal occurs, stay calm and use a gloved hand to immediately cover the open insertion site, while calling for help and staying with the patient
- Applying petroleum gauze, dry gauze, and tape to the site to create a dressing is important
- Quick action can prevent patient harm
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