Chest Tubes Nursing Care Management Assessment NCLEX Review Drainage System

Summary

In this educational video, Sarah from registernurseRN.com provides a comprehensive review of chest tubes for nursing students preparing for the INLEX exam. She covers the anatomy, types of drainage systems, purposes, and nursing interventions for chest tube care. Sarah explains the function of chest tubes, the conditions they treat, and the differences between wet and dry suction systems. She also discusses nursing responsibilities, such as monitoring patients, handling complications, and assisting with chest tube removal.

Takeaways

• 😷 Chest tubes are inserted into the pleural space to remove air or fluid to help re-expand the lung.
• 🩺 Another type of chest tube is the mediastinal chest tube, which is placed under the sternum to drain fluid around the heart after cardiac surgery.
• 🌟 Pneumothorax, pleural effusion, hemothorax, empyema, and chylothorax are common reasons for chest tube placement.
• 💧 Wet suction and dry suction are two types of chest tube drainage systems, differing in how suction is regulated.
• 🔍 Nursing interventions include monitoring the patient's respiratory status, the drainage system, and knowing how to handle emergencies like dislodged tubes or system breaks.
• 📏 The drainage collection chamber should be monitored for color and amount of drainage, typically less than 100 cc's per hour.
• 🌊 The water seal chamber fluctuates with the patient's breathing, and its normal function is essential for maintaining negative pressure in the pleural space.
• 💨 Monitoring the air leak monitor area for bubbling can indicate an air leak or normal recovery from pneumothorax.
• 🚫 Clamping the chest tube is not recommended due to the risk of increasing tension pneumothorax, and should only be done with a physician's order.
• ✂️ Chest tube removal is typically done by physicians, and involves teaching the patient the Valsalva maneuver to prevent air from entering the pleural space.

Q & A

What is the primary purpose of a chest tube?

The primary purpose of a chest tube is to remove air or fluid from the pleural space of the lungs to help re-expand the lung.

What is the role of the pleural space in the respiratory system?

The pleural space allows the two layers of pleura to glide gently over each other during breathing, creating a negative pressure that enables the lungs to inflate and deflate properly.

What is a mediastinal chest tube and where is it typically placed?

A mediastinal chest tube is a type of chest tube inserted into the mediastinum space, typically under the sternum, to drain fluid from around the heart after cardiac surgery.

What conditions can lead to the need for a chest tube?

Conditions such as pneumothorax, pleural effusion (with different types like hemothorax, empyema, and chylothorax), and post-cardiac surgery complications can lead to the need for a chest tube.

What are the two basic types of chest tube drainage systems discussed in the script?

The two basic types of chest tube drainage systems discussed are wet suction and dry suction.

How does wet suction in a chest tube system work?

Wet suction is regulated by the height of the water in the suction control chamber. The water level determines the suction pressure, and bubbling in the system is normal as it indicates the suction is working.

How does dry suction differ from wet suction in a chest tube system?

Dry suction does not use a water column. Instead, it uses a suction monitor bellows that balances with the wall suction, and it allows for higher suction pressure options without water evaporation.

What should a nurse monitor when caring for a patient with a chest tube?

A nurse should monitor the patient's respiratory status, the drainage system itself, and be prepared to handle emergencies such as a dislodged chest tube or a broken system.

What is the significance of bubbling in the water seal chamber of a chest tube system?

Bubbling in the water seal chamber can indicate an air leak. However, some intermittent bubbling can be normal, especially in patients recovering from a pneumothorax.

What is the Valsalva maneuver and why is it important during chest tube removal?

The Valsalva maneuver involves taking a deep breath, exhaling, and bearing down. It is important during chest tube removal to prevent air from entering the pleural space, which could cause a tension pneumothorax.

What typically happens after a chest tube is removed?

After a chest tube is removed, the physician may order a chest X-ray to assess lung expansion, and the nurse should monitor the patient's respiratory status and lung sounds.