NURS 311: Lab 5 - Pneumothorax (I suggest also reviewing Lab 2 material)

What is a pneumothorax?

An accumulation of air in the pleural cavity that leads to partial or complete lung collapse.

What is a hemothorax?

Bleeding in the chest cavity.

What is a pneumohemothorax?

Air and blood in the pleural space.

What is a chylothorax?

Presence of lymphatic fluid in the pleural space.

What are the 2 types of pneumothorax?

Open and closed.

What is an open pneumothorax?

A pneumothorax in which air enters the pleural space through an opening in the chest wall.

What is a closed pneumothorax?

A pneumothorax that is not associated with an external wound.

What is a tension pneumothorax?

A life-threatening complication of pneumothorax in which air continues to enter the pleural space during inspiration and does not exit during expiration.

What are the s/s of pneumothorax?

Sudden onset, pleuritic chest pain, unequal lung excursion, tachypnea, tachycardia, dyspnea, and decreased breath sounds on the affected side.

What diagnostic tools are used for pneumothorax?

Chest X-rays and ABGs.

What will a chest X-ray show for a pneumothorax?

Air in the pleural space and a possible mediastinal shift.

What will ABGs reveal for a penumothorax?

Hypoxemia and increased PaCO2.

A small pneumothorax is just as urgent as any other pneumothorax and needs treatment ASAP! (True/False)

False

What is the action for a tension pneumothorax?

Immediate needle decompression with a large-bore needle (14 to 16 gauge).

Where is the chest tube placed for air drainage?

Anteriorly through the 2nd to 4th or 5th intercostal space in the midclavicular line of the affected side.

Where is the chest tube placed for fluid and blood drainage?

Posteriorly through the 7th to 8th or 9th intercostal space.

What are the 3 chambers of a chest drainage system?

Collection chamber, water seal chamber, and wet suction control chamber.

What is the role of RNs in chest tube management?

RNs assist with the insertion and removal of chest tubes and maintain and care for them.

What is the purpose of clamping a chest tube?

To assess whether a chest tube is ready to be removed, locate an air leak, or assess bubbling and fluctuation.

How long can a chest tube be clamped?

Less than a minute.

What should be monitored after chest tube insertion?

Vital signs, respiratory status, oxygenation status, pain management, and insertion site.

What is a common cause of tension pneumothorax?

An obstructed or displaced chest tube.

What is the significance of having a bottle of sterile water at the bedside?

It is necessary in case of accidental disconnection of the chest tube.

What are the signs of infection at the chest tube insertion site?

Excessive bleeding and subcutaneous emphysema.

What should be done if a chest tube falls out?

Cover the area with dry, sterile gauze.

What should be done if a chest tube disconnects from the drainage system?

Put the end of the tube in a container of sterile water and keep it below the level of the patient's chest.