Podcast
Questions and Answers
What assessment finding would cause suspicion of an air leak?
What assessment finding would cause suspicion of an air leak?
What action should be taken before transporting a patient with a chest tube to the radiology department?
What action should be taken before transporting a patient with a chest tube to the radiology department?
What is most likely the reason for the decrease in chest tube output during assessment?
What is most likely the reason for the decrease in chest tube output during assessment?
What is the best approach by the nurse when assisting a patient with a chest tube to change positions in bed?
What is the best approach by the nurse when assisting a patient with a chest tube to change positions in bed?
Signup and view all the answers
What should the nurse conclude when assessing a patient with a chest tube and notes fluctuation in the water-seal chamber with spontaneous respiration?
What should the nurse conclude when assessing a patient with a chest tube and notes fluctuation in the water-seal chamber with spontaneous respiration?
Signup and view all the answers
What is the most appropriate response by the nurse when a family member asks if they can hold a patient with a chest tube?
What is the most appropriate response by the nurse when a family member asks if they can hold a patient with a chest tube?
Signup and view all the answers
What approach by the practitioner should the nurse anticipate when preparing for chest tube insertion to treat a hemothorax?
What approach by the practitioner should the nurse anticipate when preparing for chest tube insertion to treat a hemothorax?
Signup and view all the answers
What is the best response by the nurse when a family member asks why an intubated patient's neck looks swollen and a popping sensation is felt?
What is the best response by the nurse when a family member asks why an intubated patient's neck looks swollen and a popping sensation is felt?
Signup and view all the answers
What is the best way for the nurse to assess for an air leak when there is continuous bubbling in the water-seal compartment?
What is the best way for the nurse to assess for an air leak when there is continuous bubbling in the water-seal compartment?
Signup and view all the answers
What should the nurse consider when preparing to change out a closed drainage system?
What should the nurse consider when preparing to change out a closed drainage system?
Signup and view all the answers
What is the physiologic goal of chest tube insertion?
What is the physiologic goal of chest tube insertion?
Signup and view all the answers
What should the nurse suspect based on assessment findings of absent breath sounds, decreased oxygen saturation, and neck vein distention in a 6-year-old patient?
What should the nurse suspect based on assessment findings of absent breath sounds, decreased oxygen saturation, and neck vein distention in a 6-year-old patient?
Signup and view all the answers
How should the nurse position a patient being prepared for chest tube placement for a hemothorax?
How should the nurse position a patient being prepared for chest tube placement for a hemothorax?
Signup and view all the answers
What should the nurse do when they notice that the drainage has stopped 6 hours after chest tube placement?
What should the nurse do when they notice that the drainage has stopped 6 hours after chest tube placement?
Signup and view all the answers
Where should the nurse secure the chest tube to avoid dislodgement?
Where should the nurse secure the chest tube to avoid dislodgement?
Signup and view all the answers
Which complication should the nurse suspect in a 3-year-old patient after a motor vehicle crash, showing increased work of breathing and unequal chest rise?
Which complication should the nurse suspect in a 3-year-old patient after a motor vehicle crash, showing increased work of breathing and unequal chest rise?
Signup and view all the answers
What is the correct statement regarding chest tube size and intended use?
What is the correct statement regarding chest tube size and intended use?
Signup and view all the answers
What should the nurse know about chest tube placement when a patient is in respiratory distress?
What should the nurse know about chest tube placement when a patient is in respiratory distress?
Signup and view all the answers
What should the nurse do after inserting a chest tube into a patient?
What should the nurse do after inserting a chest tube into a patient?
Signup and view all the answers
What is the physiological reason for using chest tubes?
What is the physiological reason for using chest tubes?
Signup and view all the answers
Study Notes
Chest Tube Assessment and Air Leaks
- Continuous bubbling in the water-seal chamber suggests an air leak from the chest cavity.
- Intermittent bubbling indicates normal air drainage in pneumothorax patients.
- Tidaling in the water-seal chamber is typical with breathing; it reverses in mechanically ventilated patients.
Drainage System Management
- Maintain the chest tube drainage system below the patient's chest for gravity flow.
- Clamping should only occur to assess air leaks, not during patient transportation due to risk of tension pneumothorax.
- Avoid aggressive milking of the pleural tube, as it may dislodge or occlude the tube.
Monitoring Chest Tube Output
- A sudden decrease in drainage may signal an obstruction in the tubing.
- Assess for kinks in the tubing if drainage stops after chest tube placement.
- Collecting system fullness should be checked to ensure continued drainage.
Patient Positioning
- Secure the chest tube to the patient’s chest or abdomen to prevent dislodgment during repositioning.
- The semi-Fowler position is ideal for patients with hemothorax, while the lateral supine position is suitable for pneumothorax.
Risk Indicators
- Symptoms of tension pneumothorax include absent breath sounds on one side, decreased oxygen saturation, and neck vein distention.
- Subcutaneous emphysema is detectable by crackling sensation on palpation around the chest tube insertion site, indicating air leakage.
Equipment and Procedure Guidelines
- Suction should be activated only after the chest tube is affixed to the drainage system.
- Chest tube size is determined by the patient's weight, with smaller tubes used for air evacuation and larger ones for blood drainage.
- No absolute contraindications exist for chest tube placement in respiratory distress cases if lung reexpansion is required.
Communication with Family
- Educate family members on signs of complications and the rationale behind tube management to alleviate concerns.
- Clarify that while special conditions like bleeding disorders warrant caution, they don't constitute absolute contraindications for chest tube placement.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge on lab skills related to continuous bubbling in water-seal chambers. Understand the implications of bubbling patterns in patients with pneumothorax or those on mechanical ventilation. This quiz will help reinforce essential concepts for clinical practice.
