MDC IV Exam 2
1.What conditions is a chest tube placed for?
- Tension pneumothorax
- Hemothorax
2.What happens when a tension pneumothorax or hemothorax occurs?
Pressure on the lungs causes reduction in expansion and capacity
- will have diminished breath sounds!!
3.Treatment for a tension pneumothorax
Needle Thoracostomy
- 16 to 18 gauge catheter through the anterior chest wall in the second intercostal space at the midclavicular line
4.Where is a chest tube placed?
Midaxillary into 5th or 6th intercostal space
5.What is a chest tube connected to?
An atrium that will provide one way valve for air release or as a collection system for blood
6.Is intermittent and low frequency bubbling in the atrium normal with a chest tube?
Yes, should correspond with breathing in and out
7.Is continuous bubbling in the atrium normal?
No 8.Continuous bubbling in the atrium is bad and can indicate what?
An air leak
9.What is tidaling in the atrium?
Movement of fluid the chest tube back and forth
10.What does tidaling indicate in an atrium?
Indicates negative pressure created by the diaphragm
11.Absence tidaling can indicate what?
Occlusion
12.Nursing priority for chest tubes
- Clean site
- Monitor for drainage at insertion
- Monitor output into atrium
- Too much or too little can be harmful for the patient by increasing risk of complications
- Avoid tugging/stress on the tube.
- Atrium should remain upright, do not let it get knocked over
13.Chest tube complications
- Air leak (continuous rapid bubbling in the water seal chamber)
- No tidaling in water seal chamber
- No bubbling in suction control chamber
- Chest tube is disconnected from system
- Chest tube accidentally pulled from chest 14.Chest tube complication management
- Infection Prevention
- Worsening injury
- Monitor output
- Accidental removal
- Seal wound on ¾ sides with occlusive dressing and notify MD (this is an urgent situation)
15.What is a pulmonary embolism?
Clot in the lung(s)
16.What is the treatment of a pulmonary embolism?
- Thrombectomy
- Embolectomy
- Anticoagulants
- Antithrombotics
- IVF filter
17.Signs and symptoms of pulmonary embolism?
- Chest pain
- SOB
- Change in LOC
18.Diagnostics tests for pulmonary embolism
- CT Angiography
- D-dimer
- CBC
1.What conditions is a chest tube placed for?
- Tension pneumothorax
- Hemothorax
2.What happens when a tension pneumothorax or hemothorax occurs?
Pressure on the lungs causes reduction in expansion and capacity
- will have diminished breath sounds!!
3.Treatment for a tension pneumothorax
Needle Thoracostomy
- 16 to 18 gauge catheter through the anterior chest wall in the second intercostal space at the midclavicular line
4.Where is a chest tube placed?
Midaxillary into 5th or 6th intercostal space
5.What is a chest tube connected to?
An atrium that will provide one way valve for air release or as a collection system for blood
6.Is intermittent and low frequency bubbling in the atrium normal with a chest tube?
Yes, should correspond with breathing in and out
7.Is continuous bubbling in the atrium normal?
No 8.Continuous bubbling in the atrium is bad and can indicate what?
An air leak
9.What is tidaling in the atrium?
Movement of fluid the chest tube back and forth
10.What does tidaling indicate in an atrium?
Indicates negative pressure created by the diaphragm
11.Absence tidaling can indicate what?
Occlusion
12.Nursing priority for chest tubes
- Clean site
- Monitor for drainage at insertion
- Monitor output into atrium
- Too much or too little can be harmful for the patient by increasing risk of complications
- Avoid tugging/stress on the tube.
- Atrium should remain upright, do not let it get knocked over
13.Chest tube complications
- Air leak (continuous rapid bubbling in the water seal chamber)
- No tidaling in water seal chamber
- No bubbling in suction control chamber
- Chest tube is disconnected from system
- Chest tube accidentally pulled from chest 14.Chest tube complication management
- Infection Prevention
- Worsening injury
- Monitor output
- Accidental removal
- Seal wound on ¾ sides with occlusive dressing and notify MD (this is an urgent situation)
15.What is a pulmonary embolism?
Clot in the lung(s)
16.What is the treatment of a pulmonary embolism?
- Thrombectomy
- Embolectomy
- Anticoagulants
- Antithrombotics
- IVF filter
17.Signs and symptoms of pulmonary embolism?
- Chest pain
- SOB
- Change in LOC
18.Diagnostics tests for pulmonary embolism
- CT Angiography
- D-dimer
- CBC
