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wks
Special Procedures
| Question | Answer |
|---|---|
| Analysis of pleural fluid, what is the appearance of transludate fluid | clear, also called serous fluid, and has a light straw color |
| Transudate fluid is associated with | congestive hrt failure |
| What is Exudate fluid | empyema that has an opaque appearance |
| Pleural fluid infections would present | yellow or milky exudate fluid |
| Bloody effusions of pleural fluid would suggest | malignancy or cancer |
| In pleural fluid what is purulent | pus filled exudate |
| In pleural fluid what is mucopurulent | mucus and pus exudate |
| In pleural fluid what is chyle | lyphatic exudative fluid |
| In pleural fluid what is loculated | very thick |
| In pleural fluid ph can be measured, a ph less than 7.30 is | considered significant exudate |
| What are the 3 types of sleep apnea | central which is apnea due to loss of ventilation effort, obstructive which is apnea due to blockage of the upper airway, mixed which is a combination of the central and obstructive types |
| During the observation in the sleep lab, what happens if nasal flow and respiratory effort decreases | if nasal flow decreases and respiratory effort decreases then desaturation is the result of a central problem |
| In observation in a sleep lab, what happens if nasal flow decreases but respiratory effort increases then | desaturation is a result of an occlusive or obstructive problem |
| What is the treatment for sleep apnea | weight loss, surgery, respiratory stimulants, tracheostomy, nasal mask CPAP and or BIPAP therapy |
| What is inductive plethysmograph | series of elastic bands that are placed around the chest to measure chest movement(respiratory effort) and breathing frequency |
| Where is an inductive plethysmograph used | in sleep studies (polysomnography) to monitor chest motion |
| What is a pneumothorax | air enters the pleural space with little or no fluid, if the air is not allowed to escape it will collapse the lung pushing the mediastinum away from the effected side thus called a tension pneumothorax |
| What is a hemothorax or pleural effusion | fluid that enters the pleural cavity with no air |
| What action should be taken in the event of a pneumothorax, hemothorax or pleural effusion | insert a bore needle to relieve the pressure, theninsert a chest tube and apply the most appropriate drainage system |
| How many chest tubes can be inserted into the pleural space | 1, 2 or more |
| Where do you place the tube that is to drain AIR from the pleural space | anterior chest, second interspace in the midclavicular line |
| Where do you place the tube that is to drain FLUID from the pleural space | between the fourth and fifth interspace in the midaxillary line |
| Under the three bottle water seal suction drainage system, what does the suction control bottle regulate | amount of negative pressure being applied above the water seal |
| Under the three bottle water seal suction drainage system, the water height in the suction CONTROL bottle will determine | the amount of negative pressure regardles of the amount of suction through tube from suction source(pt body) |
| Under the three bottle water seal suction drainage system, if the pressure exceeds 10 cm h2o it will cause | air to be drawn through tube C and create bubbling |
| Under the three bottle water seal suction drainage system, if bubbling occurs then | it can be assumed that 10 cm of negative pressure is being maintained by the suction control bottle and applied to the drainage system |
| Under the three bottle water seal suction drainage system, what is the middle bottle(water seal bottle) | water seal that prevents air from entering the pleural cavity. |
| Under the three bottle water seal suction drainage system, if continuous bubbling occurs in the middle bottle or water seal bottle | this should be reported due to an air leak |
| Under the three bottle water seal suction drainage system, in the water seal bottle the sterile water should be monitored to prevent | sudden change in pleural pressure which this malfunction causing reexpansion of the lung can cause pulmonary edema |
| Under the three bottle water seal suction drainage system, tube B from the water seal bottle connects to which bottle | collection bottle |
| Under the three bottle water seal suction drainage system, if the water seal breaks | submerge the chest tube in a glass of water |
| Under the three bottle water seal suction drainage system, if the water seal breaks and the pt is on mechanical ventilation | then leave the tube open to atmospheric air until a new system can be setup |
| How many parts does the disposable drainage unit consist of | three parts and resembles the three bottle system |
| How much water do you put into the water seal chamber in a disposable drainage unit | 1 to 2 cm |
| In the disposable drainage unit what happens during spintaneous breathing | water rises toward the pt side of the chamber during inspiration and returns to the other side on expiration |
| In the disposable drainage unit what is the normal movement of water | 2 to 6 cm, movement is accentuated during greater inspiratory and expiratory effort |
| In the disposable drainage unit what happens during positive pressure ventilation | the movement of water is reversed due to the positive pressure within the thorax and the pleural cavity |
| In the disposable drainage unit if no suction is applied to the control system what happens | there will be no bubbling in the suction control chamber and the unit will resemble a two bottle gravity drainage unit |
| In the disposable drainage unit during positive pressure ventilation the height of the water in the suction control chamber will determine | the amount of suction within the pleural cavity |
| In the disposable drainage unit how much water is added to the suction control chamber | 15-20cm and should be monitored for evaporation and changes in the amount of suction |
| When using a disposable drainage unit if the pt is on mechanical ventilation what do you measure | the volume lost through chest drainage system and adjust the ventilator based on the abg |
| When do you replace the disposable drainage unit | when the collection chamber is full |
| How do you figure the volume lost through chest tubes, formula | delivered tidal volume - exhaled tidal volume = volume lost |
| How do you remove a chest tube | the tube is clamped off for 24 hours to assume normal intrapleural pressure, pt observed for respiratory distress, xray, pt takes deep breath exhales performs valsalva maneuver, tube is pulled and gauze petroleum placed over opening, then xray |
| If any signs of repiratory distress or is the xray indicates a pneumothorax or pleural effusion what happens with the chest tube | unclamped |
| What percent pneumothorax may not need any treatment unless pt shows distress | <10% |
| What percent pneumothorax will normally require a chest tube | >20% |
Created by:
buzzell6
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