NCLEX chest tube care key terms
Essential key terms and concepts related to chest tube care for NCLEX preparation, focusing on priorities for patient safety and effective nursing actions.
Quiz(56 questions)
1. What is the primary purpose of a chest tube?
Terms in this Study Set(56)
Chest Tube Basics(16)
What is a chest tube?
A chest tube is a flexible tube inserted into the pleural space to drain air, fluid, or blood.
When are chest tubes used?
- Pneumothorax - Hemothorax - Pleural effusion - Post-surgery for lung procedures
True or False: Chest tubes are only for air drainage.
False. They can also drain fluid or blood.
What are common indications for chest tube placement?
- Traumatic injury - Lung collapse - Postoperative complications - Infection in pleural space
Fill in the blank: Chest tubes help re-establish __________ pressure.
Negative pleural pressure.
What is the function of a water seal in chest tubes?
It prevents air from entering the pleural space while allowing fluid to drain.
Chest tube size range?
Typically, sizes range from 24 French to 40 French.
What is a mediastinal tube?
A tube placed in the mediastinum to drain fluid post thoracic surgery.
List two signs of chest tube malfunction.
- Lack of fluctuation in water seal chamber - Sudden increase in drainage
What should you do if a chest tube becomes dislodged?
- Apply sterile gauze over the site - Call for help - Monitor the patient
How often should chest tube drainage be assessed?
Every shift and PRN (as needed).
True or False: Suction is always used with chest tubes.
False. Suction is used as needed based on patient condition.
What does an increase in drainage indicate?
Possible complications such as bleeding or infection.
What is the purpose of a chest tube clamp?
To temporarily occlude the tube, but it should be used cautiously.
What do you check before chest tube removal?
- Stable respiratory status - Adequate lung re-expansion - Minimal drainage
What is tidaling in a chest tube?
The movement of fluid in the water seal chamber with breathing.
Assessment and Monitoring(14)
What should you assess for in chest tube management?
Respiratory rate, lung sounds, chest movement, and pain level.
True or False: Fluctuation in chest tube water seal indicates normal function.
True - This indicates the lung is re-expanding.
Fill in the blank: Normal respiratory rate ranges from _____ to _____ breaths per minute.
12 to 20
What vital sign is critical in chest tube assessment?
Pulse oximetry – Normal SpO2 is 95%-100%.
What should you monitor for with chest tube drainage?
Color, consistency, and amount of drainage.
Cause → Effect: What happens if the chest tube is kinked?
Increased respiratory distress due to blocked airflow.
What does a sudden increase in drainage indicate?
Potential hemorrhage or reexpansion pulmonary edema.
How do you assess for subcutaneous emphysema?
Palpate around the chest tube site for crepitus.
True or False: Lung sounds should be assessed only once a shift.
False - Assess lung sounds regularly for changes.
What is the purpose of checking chest tube suction?
To ensure optimal drainage and lung re-expansion.
What is the expected drainage after a chest tube placement?
Serous fluid initially; then, it should decrease over time.
What indicates a need for immediate intervention?
Sudden cessation of tidaling in the water seal chamber.
How often should vital signs be monitored after chest tube insertion?
Every 2-4 hours based on patient stability.
What is a priority nursing action if a patient reports sudden chest pain?
Assess lung sounds and check for any complications.
Complications and Interventions(14)
What are common chest tube complications?
Pneumothorax, hemothorax, infection, tube dislodgment, occlusion.
True or False: A dislodged chest tube can lead to a tension pneumothorax.
True. Dislodgment can cause air to enter the pleural space, leading to increased pressure.
Fill in the blank: A _______ occurs when fluid collects in the pleural space.
hemothorax or pleural effusion.
What should you do if the chest tube becomes dislodged?
Cover with a sterile dressing, secure it, and notify the provider immediately.
How to recognize a chest tube obstruction?
- Sudden decrease in drainage - Respiratory distress - Diminished breath sounds
What is the primary intervention for a pneumothorax?
Insert a chest tube to re-establish negative pressure in the pleural space.
Cause → Effect: What happens if the chest tube is clamped?
Increased pressure can lead to lung collapse or tension pneumothorax.
What should be monitored during chest tube care?
Respiratory rate, oxygen saturation, drainage amount and characteristics.
Identify a sign of infection at the chest tube site.
Redness, swelling, warmth, or purulent drainage.
When should you check the water seal chamber?
At least every shift and when assessing for complications.
What does continuous bubbling in the water seal indicate?
An air leak in the system.
How should the chest tube be positioned?
Below the level of the chest to facilitate drainage.
True or False: Patients with chest tubes should be in a flat position.
False. Semi-Fowler's position is preferred to ease breathing.
What is a sign of tube obstruction?
Drainage changes from serous to serosanguineous or absent.
Patient Education(12)
What should you report immediately?
Increased drainage, sudden changes in respiratory status, or signs of infection.
True or False: You should milk the chest tube.
False. Milking can increase pressure and damage the lung tissue.
Explain deep breathing exercises.
Helps expand lungs, prevent complications. Inhale deeply, hold, exhale slowly.
What to avoid near the chest tube?
Avoid pulling, tugging, or disconnecting the tube. Keep the area clean.
Fill in the blank: Chest tubes are used to ______.
Remove air or fluid from the pleural space.
When can a patient shower?
After the provider approves, usually when the site is healed.
Why is it important to keep the drainage system below chest level?
Prevents backflow, maintains proper drainage, and reduces complications.
What to do if the tube comes out?
Cover the site with a sterile dressing and notify the healthcare provider immediately.
How to maintain proper tube function?
Ensure no kinks, monitor drainage, and keep connections secure.
What is a sign of infection?
Increased redness, warmth, swelling, or discharge at the site.
True or False: Patients should avoid coughing.
False. Coughing is encouraged to clear lungs, but do it carefully.
What are common comfort measures?
Pain management, positioning for comfort, and relaxation techniques.
Questions in this Study Set(56)
1. What is the primary purpose of a chest tube?
2. What is a common complication associated with chest tubes?
3. What is the normal range for respiratory rate in adults?
4. What is the primary purpose of a chest tube?
5. In which situation would a chest tube be most likely placed?
6. What action should you take if you notice continuous bubbling in the water seal chamber?
7. Which of the following indicates normal functioning of a chest tube?
8. Which of the following should a patient report immediately?
9. True or False: The water seal in a chest tube system allows air to enter the pleural space.
10. Which of the following is NOT a sign of infection at the chest tube site?
11. What does increased drainage from a chest tube often indicate?
12. True or False: It is safe to milk the chest tube to ensure proper drainage.
13. What might a sudden increase in drainage from a chest tube indicate?
14. If a chest tube becomes dislodged, what is the first step you should take?
15. Which of the following is NOT a sign of respiratory distress?
16. When is it usually safe for a patient to take a shower after chest tube placement?
17. Which chest tube size is typically smaller?
18. What condition is a primary reason for inserting a chest tube?
19. What is a priority nursing action when tidaling ceases in the water seal chamber?
20. Which scenario demonstrates appropriate care for a chest tube?
21. What should be monitored in the water seal chamber of a chest tube?
22. In which position should a patient with a chest tube be placed for optimal breathing?
23. After chest tube insertion, how often should lung sounds be assessed?
24. What should a patient do if their chest tube accidentally comes out?
25. What is a common sign that a chest tube is malfunctioning?
26. What does a sudden decrease in drainage from the chest tube suggest?
27. What does subcutaneous emphysema feel like upon palpation?
28. What is a common sign of infection at the chest tube site?
29. When is it appropriate to use suction with a chest tube?
30. What should you monitor to assess the effectiveness of chest tube therapy?
31. What is the initial expected drainage type after chest tube placement?
32. True or False: Patients should avoid coughing to prevent dislodging the tube.
33. What is the first action to take if a chest tube becomes dislodged?
34. What is a potential consequence of clamping a chest tube?
35. What critical vital sign should be monitored closely after chest tube insertion?
36. Which action is NOT a recommended comfort measure for a patient with a chest tube?
37. Which of the following is NOT a common indication for chest tube placement?
38. Which of the following indicates a possible hemothorax?
39. What should be assessed if a patient reports sudden chest pain after tube placement?
40. Which of the following should be avoided near the chest tube?
41. When preparing to remove a chest tube, which assessment is crucial?
42. What is an appropriate nursing action if you observe respiratory distress in a patient with a chest tube?
43. What signifies a potential complication with chest tube drainage?
44. How can a nurse maintain proper function of a chest tube?
45. What is the primary reason for using a mediastinal tube?
46. When should the water seal chamber be checked?
47. How does a kink in the chest tube affect the patient?
48. Fill in the blank: Deep breathing exercises help to ______.
49. What does tidaling in a chest tube reflect?
50. Fill in the blank: A _______ occurs when fluid collects in the pleural space.
51. What should be monitored in the drainage collection chamber of a chest tube?
52. Which nursing action is essential after chest tube insertion?
53. Which of the following is a sign of tube obstruction?
54. What is the expected change in drainage volume over time?
55. True or False: Chest tubes are primarily used for oxygen delivery.
56. Which function does the water seal provide in a chest tube system?
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