Pneumothorax Overview and Types
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Questions and Answers

Which of the following actions is considered a nursing intervention to maintain patency of a chest tube drainage system?

  • Clamp the chest tube securely to check for air leaks
  • Apply intermittent pressure to the suction control chamber
  • Keep tubing loosely coiled and tape connections (correct)
  • Elevate the drainage system above the patient's chest

    • The water-seal chamber in a chest tube drainage system acts as a one-way valve. What observation is indicative of an air leak in this chamber?

  • Continuous bubbling (correct)
  • Drainage in the collection chamber
  • Intermittent bubbling
  • Absence of tidaling

    • What is the rationale for encouraging deep breathing, range-of-motion exercises, and incentive spirometry in a patient with a chest tube?

  • To promote lung expansion and prevent atelectasis (correct)
  • To prevent the formation of subcutaneous emphysema
  • To enhance drainage of fluids from the pleural space
  • To relieve pain and improve comfort

    • What is the appropriate action for a nurse to take when observing tidaling in a patient with a chest tube?

    <p>Document the finding as normal and continue monitoring (C)</p> Signup and view all the answers

    A patient with a chest tube develops subcutaneous emphysema. What nursing intervention is appropriate for this complication?

    <p>Monitor the patient closely and document the finding (C)</p> Signup and view all the answers

    What is the purpose of using petroleum gauze around the chest tube insertion site?

    <p>To prevent air leaks and maintain a sterile environment (D)</p> Signup and view all the answers

    What is the primary reason for reviewing a patient's medication record for anticoagulation therapy before inserting a chest tube?

    <p>To assess the patient's risk for bleeding complications (B)</p> Signup and view all the answers

    What is the correct action for a nurse to take if a patient's chest tube drainage is significantly decreasing?

    <p>Immediately clamp the chest tube and notify the physician (A)</p> Signup and view all the answers

    What is the appropriate nursing intervention for a patient with a chest tube who is experiencing pain?

    <p>Administer pain medication as prescribed and provide comfort measures (B)</p> Signup and view all the answers

    What nursing assessment is essential to monitor for potential complications in a patient with a chest tube?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following clinical manifestations is NOT associated with pneumothorax?

    <p>Increased breath sounds over the affected area (A)</p> Signup and view all the answers

    A patient presents with a sucking chest wound. What type of pneumothorax is this most likely to be?

    <p>Traumatic penetrating pneumothorax (A)</p> Signup and view all the answers

    Which of the following situations would NOT typically necessitate the use of a chest tube for pneumothorax?

    <p>Small pneumothorax resolving spontaneously (A)</p> Signup and view all the answers

    Which of the following is a potential complication of tension pneumothorax?

    <p>Both A and C (B)</p> Signup and view all the answers

    A patient with a pneumothorax presents with severe respiratory distress and tracheal deviation. What is the most likely type of pneumothorax?

    <p>Tension pneumothorax (B)</p> Signup and view all the answers

    What is the primary purpose of a vent dressing applied to a sucking chest wound?

    <p>Both A and B (B)</p> Signup and view all the answers

    Which of the following is NOT a sign of respiratory distress in a patient with chest trauma?

    <p>Increased breath sounds (A)</p> Signup and view all the answers

    In a dry suction chest drainage system, what is the function of the suction control chamber?

    <p>Regulates the amount of suction applied (D)</p> Signup and view all the answers

    When managing a patient with a chest tube, which of the following actions would NOT be appropriate?

    <p>Milking the chest tube to remove clots (A)</p> Signup and view all the answers

    Which of the following conditions would NOT be treated with a chest tube?

    <p>Spontaneous pneumothorax (D)</p> Signup and view all the answers

    Flashcards

    Pneumothorax

    Air enters the pleural cavity causing lung collapse.

    Tension Pneumothorax

    Accumulation of air in pleural space leading to mediastinal shift.

    Iatrogenic Pneumothorax

    Pneumothorax caused by medical procedures.

    Traumatic Penetrating Pneumothorax

    Pneumothorax caused by a penetrating injury.

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    Hemothorax

    Presence of blood in the pleural space.

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    Hemopneumothorax

    Combination of blood and air in the pleural space.

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    Chest Tube

    A tube used to remove air or fluid from the pleural space.

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    Dry Suction Chest Drainage

    A chest unit with three chambers used for fluid drainage.

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    Clinical Manifestations of Pneumothorax

    Symptoms include dyspnea, chest pain, and absent breath sounds.

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    Emergency Management for Chest Trauma

    Assess for respiratory distress symptoms like cyanosis and decreased breath sounds.

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    Dry Suction

    A system that uses a vacuum without water to assist drainage.

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    Water Suction

    A drainage system that uses water to create suction pressure.

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    Suction Control Chamber

    The chamber that regulates wall suction pressure in chest drainage.

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    Collection Chamber

    The first compartment that collects fluid or air drained from the chest.

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    Tidaling

    Normal fluctuation in the water-seal chamber during breathing.

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    Air Leak

    Indicated by continuous bubbling in the water-seal chamber.

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    Subcutaneous Emphysema

    Presence of air under the skin, different from crepitus.

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    Dressing Care

    Maintaining sterile occlusive dressing to prevent air leaks.

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    Patient Assessment

    Reviewing vital signs and lung sounds, and checking for infection.

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    Study Notes

    Pneumothorax

    • Caused by air entering the pleural cavity, resulting in lung collapse
    • Can be open or closed
    • Open pneumothorax: air rushes in due to chest wall disruption
    • Closed pneumothorax: air rushes out due to visceral pleura disruption
    • Causes variable clinical manifestations, from mild tachycardia and dyspnea to severe respiratory distress
    • Characteristic symptoms include chest pain and cough
    • Absent breath sounds over the affected area may be observed
    • Diagnosis is made through chest X-rays and arterial blood gases (ABGs)
    • Causes of pneumothorax include ruptured blebs (associated with COPD), trauma, or secondary infections
    • Treatment may involve thoracentesis (removal of air) or chest tube insertion is needed for ongoing issues.

    Types of Pneumothorax

    • Iatrogenic: Caused by medical procedures like central line insertion or thoracentesis
    • Traumatic (penetrating): Can cause a sucking chest wound
    • Traumatic (blunt): Lung laceration or alveolar rupture

    Tension Pneumothorax

    • Accumulation of air in the pleural space that doesn't escape
    • Causes mediastinal shift and hemodynamic instability
    • A critical condition requiring immediate treatment
    • Treated with needle decompression in the second intercostal space at the midclavicular line, followed by tube thoracostomy.

    Types of Pneumothorax in Relation to Pressure

    • Closed: Pleural cavity pressure is less than atmospheric pressure
    • Open: Pleural cavity pressure equals atmospheric pressure
    • Tension: Pleural cavity pressure is greater than atmospheric pressure; air cannot escape.

    Collaborative Care for Pneumothorax

    • Treatment based on severity
    • May resolve spontaneously
    • Thoracentesis for smaller amounts of air/fluid
    • Chest tubes for ongoing issues
    • Urgent needle decompression for tension pneumothorax

    Chest Trauma

    • Hemothorax: Blood in the pleural space. Treatment is with a chest tube.
    • Hemopneumothorax: Blood and air in the pleural space. Treatment is with a chest tube.

    Chest Trauma: Emergency Management

    • Assess for respiratory distress
    • Evaluate symptoms like dyspnea, cough (with or without hemoptysis), cyanosis
    • Check for tracheal deviation (a sign of tension pneumothorax)
    • Note decreased breath sounds and O2 saturation
    • Evaluate for frothy secretions

    Chest Tube: Dry Suction

    • Specialized drainage unit with three chambers (collection, water-seal, and suction control)
    • A wall suction source is used to control the suction level
    • Used for removing air or fluid from the pleural/mediastinal space

    Chest Tube: Water Suction

    • Similar chambers to the dry suction unit (collection, water-seal, suction control).
    • Wall suction is used to control the suction level for the suction control chamber

    Chest Tubes and Pleural Drainage

    • Designed to remove air or fluid from the pleural and/or mediastinal spaces
    • Re-establishes negative pressure for lung re-expansion
    • Ranges in size from 12F to 40F
    • Various sizes (12F - 40F)

    Nursing Management of Chest Tubes

    • Maintaining patency of the drainage system
    • Keeping tubing loosely coiled and taping connections
    • Observing tidaling and bubbling to assess function
    • Checking for air leaks
    • Monitoring drainage amounts/character as well as the chest tube site
    • Assessing other respiratory issues as needed (e.g., pain, subcutaneous emphysema)
    • Monitoring patient for complications (e.g., subcutaneous emphysema)

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    Chest Tubes PDF

    Description

    This quiz covers the key aspects of pneumothorax, including its causes, symptoms, diagnosis, and treatment methods. Learn about the differences between open and closed pneumothorax, as well as various types such as iatrogenic and traumatic pneumothorax. Test your understanding of this critical respiratory condition!

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