Show Notes
1. Understand the mechanism of breathing. Pressure relationships in the thoracic cavity: • intrapulmonarypressure • intrapleuralpressure • importanceof negative pressure in intrapleural space
2. Understand the rationale for insertion of chesttubes in specific medical-surgical conditions. • Thoracotomy • Lobectomy • Pneumothorax • Empyema 3. Understand the rationale of a water-seal system. • Preventreentry of air into the lung 4. Understand three mechanisms to drain fluid andair from the pleural cavity. • Positiveexpiratory pressure, deep breathing, and coughing • Gravity • Suction 5. Understand four types of pleural drainagesystems. Pleura-evac: • wetsuction control chamber • drysuction control chamber • Heimlichvalves • pigtailcatheters 6. Understand nursing responsibilities in caring for aclient with chest tubes. Assessment of client • vitalsigns • lungsounds • clinicalsigns of complications • respiratorystatus • dressing • discomfort
Maintaining chest tubes and closed chest drainage: • ensuringthat the system is airtight. • assessmentof drainage in the collection container • assessmentof fluctuation of fluid level in the water-seal chamber of the Pleura-evac unit • assessmentfor intermittent bubbling in the water of the water-seal chamber • assessmentfor gentle bubbling in the suction control chamber • inspectionof the air vent • inspectionof the drainage tubing for kinks or loops • Chesttube dressing changes as per hospital protocol.
More from Nursing School - Audio Review
Understand the etiology and pathophysiology of ChronicKidney Disease (CKD) • What is CKD? • High risk groups • Stages of CKD 9. Recognize the clinical manifestations associated with CKD • Clinical manifestations of chronic uremia affecting bodily systems.
1. Review the structures and functions of thekidney. • Functionsof the nephron • Functionsof the kidneys 2. Understand the etiology and pathophysiology ofAcute Kidney Injury (AKI). Common causes of AKI • Prerenal • Intrarenal • Postrenal 3. Describethe clinical manifestations associated with AKI. Manifestations associated with: • Prerenal • Intrarenal • Postrenal Manifestations associated with the phases of acute tubularnecrosis (ATN): • Initiationphase • Maintenancephase • Recoveryphase 4. Understandthe diagnostic studies associated with AKI. • Urinalysis • Renalultrasound • Renalscan • Computedtomography (CT) • Retrogradepyelogram • Bloodwork (serum Cr, BUN, electrolytes) 5. Understandthe treatment modalities and interventions in AKI. • Treatmentof precipitating cause • Fluidrestrictions • Crystalloids • Nutritiontherapy • Treatmentsof hyperkalemia (including pharmacotherapy) • Calciumsupplements or phosphate-binding agents • Totalparenteral nutrition (if indicated) • Enteralnutrition (if indicated) • Renalreplacement therapy (RRT) (if indicated) 6. Understandpharmacological interventions in AKI. • Antihypertensives • Diuretics • Treatmentsof hyperkalemia • Calciumsupplements or phosphate-binding agents 7. Apply thenursing process in patients with AKI. • Nursingassessment (including nursing diagnoses) • Planning/goals • Nursingintervention • Evaluation
1. Define chest trauma. 2. Identify the causes of chest injury. • Planned-Surgical • Unplanned accidents 3. Identify the common types of planned chest surgery. • Thoracotomy • Pneumonectomy • Lobectomy • Wide resection • Segmental resection 4. Describe classifications of chest trauma. Penetrating Non-penetrating 5. Understand the methods of assessing chest trauma. Initial Assessment ABCs History Physical Examination Chest x-ray Laboratory tests ABGs ECG 6. Understand the complications of severe chest trauma. Pneumothorax Open pneumothorax Mediastinal flutter Tension Pneumothorax and mediastinal shift Hemothorax Fractured ribs Flail chest
1. Describe airway obstruction. a. Complete airway obstruction b. Partial airway obstruction c. Symptoms of airway obstruction d. Interventions to re-establish apatent airway 2. Understand the relevantterminologies. a. Tracheotomy b. Tracheostomy c. Cuffed and uncuffed tubes 3. Recognize the purposes and advantagesof a tracheostomy. a. Bypass airway obstruction. b. Facilitate removal of secretions. c. Long-term mechanical ventilation. d. Permit oral intake and speech inpatients on long-term Mechanical ventilation. 4. Describe the different types oftracheostomy tubes a. Tracheostomy tube with cuff and pilotballoon b. Fenestrated tracheostomy tube(Shiley, Portex) with cuff, inner cannula, decannulation plug, and pilotballoon c. Speaking tracheostomy tube (Portex,National)) with cuff, two external tubing d. Tracheostomy tube (Bivona Fome-cuf)foam-filled cuff 5. Describe the different parts of atracheostomy tube a. Flange b. Outer cannula c. Inner cannula d. Obturator e. Pilot balloon f. Cuff g. Inflation tube h. 15-mm adapter i. Tracheostomy tie strings 6. Understand how certain medical healthproblems may benefit from a tracheostomy. a. Head, neck or chest illnesses,injuries, or surgeries b. Respiratory failure c. Neurological trauma or disorders d. Severe pulmonary edema or pulmonaryinfections with copious sputum production 7. Identify complications and interveneappropriately. a. Abnormal bleeding/hemorrhage b. Tube dislodgement c. Tube Obstruction d. Tube dislodgement/Decannulation e. Cuff leak f. Inflammation of tracheostomy stoma orpressure area around the TT g. Subcutaneous emphysema h. Tracheal stenosis i. Tracheoesophageal fistula j. Hypoxemia/hypoxia/ hypercapnia 8. Identify actual and/or potentialnursing diagnoses in patients with tracheostomy a. Ineffective airway clearance b. Impaired verbal communication c. Potential for aspiration d. Potential for infection e. Knowledge deficit f. Anxiety g. Altered body image 9. Identify nursing management inpatients with tracheostomy. a. Assessment b. Suctioning c. Tracheostomy care d. Delegation e. Role of hydration and humidity