Pneumothorax and Hemothorax in Patient-Centered Care

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary role of respiratory services in the care of a client with pneumothorax?

Chest tube management

Breathing treatments and suctioning (correct)

Rehabilitation care

Pain management

What is the primary goal of chest tube insertion in the treatment of pneumothorax?

To promote lung expansion

To relieve pain

To restore normal intrapleural pressure (correct)

To facilitate smoking cessation

What should the nurse prioritize when caring for a client with a chest tube?

Providing emotional support to the client and family

Promoting coughing and deep breathing exercises

Administering pain medications

Monitoring chest tube drainage and client status (correct)

What is a common cause of a tension pneumothorax?

Kinks or obstruction in the tubing Signup and view all the answers

What is an essential aspect of client education for pneumothorax management?

Proper hand hygiene practices Signup and view all the answers

What is a sign of respiratory distress in a client with a pneumothorax?

Tracheal deviation Signup and view all the answers

What is a potential complication of pneumothorax that the nurse should monitor for?

All of the above Signup and view all the answers

What is a crucial aspect of nursing care during chest tube insertion?

Obtaining informed consent Signup and view all the answers

What should the nurse do immediately when a tension pneumothorax is suspected?

Notify the provider and rapid response team Signup and view all the answers

Why is pulmonary services consultation important for clients with pneumothorax?

For pulmonary care and chest tube placement Signup and view all the answers

What should the client do during chest tube removal to reduce the risk of an air embolus?

Take a deep breath, exhale, and 'bear down' (Valsalva maneuver) Signup and view all the answers

Why are chest x-rays prescribed after chest tube removal?

To verify the continued resolution of pneumothorax, hemothorax, and/or pleural effusion Signup and view all the answers

What is a key aspect of rehabilitation care for clients with pneumothorax?

Assisting with increasing levels of activity Signup and view all the answers

What should the nurse monitor for after chest tube removal?

Excessive wound drainage, signs of infection, or recurrent pneumothorax Signup and view all the answers

What is a potential complication of a pneumothorax?

All of the above Signup and view all the answers

What should the nurse assist the provider with before removing the chest tube?

Assisting with suture and chest tube removal Signup and view all the answers

What is the immediate action to be taken if the chest tube becomes disconnected from the drainage system?

Instruct the client to exhale as much as possible and cough to remove air from the pleural space Signup and view all the answers

What is the purpose of instructing the client to cough and exhale when the chest tube becomes disconnected?

To remove air from the pleural space Signup and view all the answers

What is the nursing action to take if an air leak is noted in the water seal chamber?

Check all connections and tighten them securely Signup and view all the answers

What is the priority nursing action if a chest tube is accidentally removed?

Dress the area with dry, sterile gauze and occlusive dressing Signup and view all the answers

What is a medical emergency that requires immediate attention?

Tension pneumothorax Signup and view all the answers

What is the purpose of monitoring the water seal chamber?

To detect air leaks Signup and view all the answers

What should be done if the chest drainage system is compromised?

Immerse the end of the chest tube in sterile water Signup and view all the answers

What should be done immediately if the chest tube is noted to be disconnected from the drainage system?

Reestablish the chest tube connection Signup and view all the answers

Study Notes

Interprofessional Care for Pneumothorax and Hemothorax

Respiratory services are consulted for ABGs, breathing treatments, and suctioning (airway management)
Pulmonary services are consulted for chest tube management and pulmonary care
Pain management services are consulted if pain persists or is uncontrolled
Rehabilitation care is consulted if the client has prolonged weakness and needs assistance with increasing their level of activity

Therapeutic Procedures for Pneumothorax and Hemothorax

Chest tube insertion is used to drain fluid, blood, or air, reestablishing negative pressure, facilitating lung expansion, and restoring normal intrapleural pressure
Nursing actions for chest tube insertion include:
- Obtaining informed consent, gathering supplies, and monitoring vital signs and chest tube drainage
- Reporting abnormalities to the provider and administering pain medications as prescribed
- Continuously monitoring vital signs and the client's response to the procedure
- Monitoring chest tube placement, function of the chest drainage system, and dressing

Client Education for Pneumothorax and Hemothorax

Participate in coughing, deep breathing, and use of incentive spirometry
Take rest periods as needed
Use proper hand hygiene to prevent infection
Obtain immunizations for influenza and pneumonia
Recovery from a pneumothorax/hemothorax can be lengthy
Emotional support should be provided to the client and family
Consider smoking cessation if applicable
Follow up with the provider as instructed and report:
- Upper respiratory infection
- Fever
- Sucking chest wounds, prolonged clamping of the tubing, kinks or obstruction in the tubing, or mechanical ventilation with high levels of positive end-expiratory pressure (PEEP)

Tension Pneumothorax

Assessment findings include:
- Tracheal deviation (toward the unaffected side)
- Absent breath sounds on the affected side
- Distended neck veins
- Respiratory distress
- Asymmetry of the chest
- Cyanosis
Notify the provider and rapid response team immediately
Immediate treatment with needle decompression is necessary

Chest Tube Removal

Provide pain medication 30 minutes before removing the chest tube
Assist the provider with suture and chest tube removal
Instruct the client to take a deep breath, exhale, and "bear down" (Valsalva maneuver) or to take a deep breath and hold it during chest tube removal
Apply an airtight sterile petroleum jelly gauze dressing, secured with a heavyweight stretch tape
Obtain chest x-rays as prescribed to verify the continued resolution of pneumothorax, hemothorax, and/or pleural effusion

Complications of Chest Tubes

Air leaks can result if a connection is not taped securely
- Monitor the water seal chamber for continuous bubbling (air leak finding)
- Locate the source of the air leak and intervene accordingly
- Check all connections
- Notify the provider if an air leak is noted
Accidental disconnection, system breakage, or removal can occur at any time and require immediate provider or rapid response team notification
- If the tubing separates from the drainage system, instruct the client to exhale as much as possible and to cough to remove as much air as possible from the pleural space
- If the chest drainage system is compromised, immerse the end of the chest tube in sterile water to provide a temporary water seal
- If a chest tube is accidentally removed, dress the area with dry, sterile gauze (occlusive dressing taped on three sides, providing a one-way valve for air to escape)

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the interprofessional care for patients with pneumothorax and hemothorax, including consultations for respiratory, pulmonary, pain management, and rehabilitation services.