chest drains

Descripción

Fichas sobre chest drains, creado por Elizabeth Then el 12/06/2018.
Elizabeth Then
Fichas por Elizabeth Then, actualizado hace más de 1 año
Elizabeth Then
Creado por Elizabeth Then hace casi 6 años
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Pregunta Respuesta
chest injury blunt, crush, penetrating, inhalation, aspiration, compression, distraction
major force that lead to injury - compression results in destruction of vascular components, haemorrhage, oedema, and impairment of function
major force within chest that leads to injury distraction results in shearing force which destroys integrity of intrathoracic viscera
chest drains- pulmonary pressure cariation inhalation - diaphragm presses the abdo organs down and forward exhalation - diaphragm rises and recoil to resting position
ventilation perfusion ratio v - ventilation air that reaches alveoli q - perfustion - blood that reaches alveoli via the capillaries defined as - amount of air reaching the alveoli per minute to amount of blood reaching alveoli per minutes these 2 values show blood oxygen and carbon dioxide concentrations
indications for a chest drain persistent pneumothorax, tension, traumatic, any patient with pneumothorax requiring positive pressure ventilation emphysema, hamorrhagic collection
tension pneumothoraz tracheal shift, compressed lungs, compressed vessels, pleural space filled with air, compressed heart
traumatic pneumothorax traumatic rupture in chest wall, inhalation where air enters injured side causing collapsed lungs
chylothorax type of pleural effuction resulting from lymphativ fluid accumulating in pleural cavity
insertion of chest drain entry into the thoracic cavity - fogging of tube, resp swing, bubbling, coughing x-ray confirmation - ensure lung expands, screen for complications
complication of insertion traumativ perforation of lung trauma to intercostal neurovascular bundle re-expansicon of pulmonary oedema infection at site or pleural space
nursing management safety, suction, dressing, tubing, bottle, unit, daily assessment, documentation
nursing management -daily assessment volume, nature of drainage, regular chest x-rays, air leaks, dressing, pain, positioning
complications signs of pneumothorax - decrease sao2, increased wob, breth sounds decreased, hypotension, decreased chest movement notify mo, urgent CXR, -bleeding at drain site - apply pressure, place non-occlusive dressing over site -infection notify mo, swab wound site, consider blood cultures
accidental disconnection clamp tubing, clean ends of drain, reconnect, ensure unclamped once solved
accidental drain removal apply pressure to site, steri strips, place occlusive dressing over top check vital, mo
nursing documentation each shift -drainage amount, fbc, swining, bubbling, appearance, tube placement, patency, pain
removal mo-written order absense of an air leak drainage diminishes no resp compromise CXR - lung re-expansion ensure pt fasted, adequate pain control, sedation, distraction therapy
post removal care attend to pt comfort, sedation, CXR performed, clinical status best indicator monitor vitals, document removal, remove sutures after 5 days post removal, dressing insitu for 24 hours post removal
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