What does it mean when there is excessive bubbling in the water seal chamber quizlet?

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Terms in this set [26]

true

T or F
the purpose for chest drainage is to re-establish pleural space--> restores the negative intrathoracic pressure needed for lung re-expansion after surgery or trauma

traditional water seal
dry suction water seal

what are the 2 types of chest drainage systems used?

collection
water seal
wet suction control

what are the 3 chambers in a traditional water seal?

wet suction

the traditional water seal is also know as.......

water seal

prevents backflow into pleural space by means of gravity or suction.

--water level reflects the negative pressure present in the intrathoracic cavity

tidaling

water seal moves up and down with inspiration/expiration

indicates chest tube is working properly

bubbling

intermittent is a normal--good finding

if continuous---its abnormal--bad!

what is this describing?

true

T or F
if there is continuous bubbling in the water seal--> there could be an air leak!!!! check it out!

true

T or F
if the water seal has no tidaling...it could be d/t:
--the lung is fully inflated & chest tube is no longer needed
OR
--the tubing could be occluded and not working
--roger

negative

wet suction control [on the traditional water seal] maintains constant ________________pressure

suction
fluid
one
pleural

wet suction control
--maintains constant [-] pressure
--___________may be added
--promote drainage of _________
--promote air removal
--when suction is turned on: continuous bubbling appears in suction chamber
--water seal has ________way valve that prevents movement of air back into the ____________space

true

T or F

the difference between a traditional water seal and a dry suction water seal is the suction chamber--it is regulated with a valve [mechanical]

tension
milk
tidaling
air leak

troubleshooting chest drainage system KNOW!

--ensure that the drainage tubing does not kink, loop, or interfere with the pt's movements, it could cause a ____________pneumothorax

--gently "________" the tubing in the direction of the drainage chamber as needed

--make sure there is fluctuation ["____________"] of the fluid level in the water seal chamber [in wet systems], OR check the _____ _______ indicator for leaks [in dry systems with a one-way valve]

bubbling
bubbling
external

troubleshooting chest drainage system [pg 527]KNOW!

--observe for air leaks in the drainage system; they are indicated by constant _____________ in the water seal chamber or by the air leak indicator in dry systems with a one-way valve.

--In addition, assess the chest tube system for correctable external leaks.

--notify the primary provider immediately of excessive ______________ in the water seal chamber not due to ______________leaks

below
sterile
clamp

troubleshooting chest drainage system KNOW!
[pg 527]
--if the patient is lying on a stretcher and must be transported to another area, place the drainage system _____________ the chest level.

--if the tubing disconnects, cut off the contaminated tips of the chest tube & tubing, insert a ______________ connector in the cut ends, and reattach to the drainage system.

--do not __________ the chest tube during transport

valsalva
removed
petrolatum

troubleshooting chest drainage system KNOW!
[pg 527]
--when assisting in the chest tubes removal, instruct the pt to perform a gentle ______________maneuver or to breathe quietly.

--the chest tube is then clamped and quickly ______________.

--simultaneously, a small bandage is applied and made airtight with ______________gauze covered by a 4X4 inch gauze, tape 3 sides to avoid tension pneumo

kinks

if there is no tidaling......check for ___________!

dependent

maintain drainage system upright and always ________________ to prevent relux

true

T or F
full physical assessment for pre-op mgmt:
--HR & rhythm
--EKG
--auscultation
--art line
--labs: CBC, CMP, PT/INR, type & cross for transfusion
--central line
--CVP monitor

true

T or F
if chest tube comes out of patient.....

-cover up & tape on 3 sides to not cause tension pneumo [hint, hint]

--if kinked-->tension pneumo can arise

--if tidaling stops and had lots of previous drainage....start milking from the pt to the drainage system......if still no tidaling--> call surgeon!

--what if tube detaches from system?...grab bottle of NS & put tube in it

--roger

true

T or F
when the pt is ambulatory...they must carry the system along with them

clamp

do not ___________ the tube during transport, if you need to take them off of the wall suction.... just leave it to dependent drainage

true

T or F

if tube becomes disconnected from chest drainage container:
--place end of tube in 1 inch of sterile NS to prevent air from leaking back into tube
--then, replace/reconnect to new container

true

T or F

always pre-medicate [pain meds] prior to activity...such as turn, cough or deep breathe & suctioning!!

patients will listen and do more if they feel less pain.--roger

#1] impaired gas exchange
#2] ineffective airway clearance
#3] acute pain

in order, what are the 3 major nursing diagnoses?

yes

can a client with chest tube have a tension pneumothorax?

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What does it mean when there is excessive bubbling in the water seal chamber?

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