Thoracic surgery is done to

remove tumors, abscessess, resection a segment, lobe or full lung, repair esophagus ot thoracic vessels

Preoperative considerations include

lung function, cardiac function, tumor removal, pain management

Postoperative complications

pain, acute respiratory failure, PNA, other (hemorrhage, mediastinal shift, bronchopleural fistula, CV compromise)

Hemorrhage is life threatening postop

most likely occurs immediately after surgery, causes due to dislodge sutures or clip, bleeding from intercostal/bronchial artery

Potential indicators for hemorrhage

fresh red blood, sudden increase in drainage, drainage volume exceeding 100ml/hour

Bronchopleural fistula indicators

suture line does not hold(compromised by mechanical ventilation & high airway pressures, early weaning is goals), SOB, cough, hemoptysis

Mediastinal shift due to

acumulation of fluid or an increase in pressure on the surgical side, must remove air & fluid on surgical side

CV complications can occur

when large volume of lung tissue & pulmonary vascular bed is resectioned, use vasoactive medications to optimize cardiac function

Indicators of pain to monitor for

tachypnea, tachycardia, elevated BP, grimacing, splinting, moaning, increase restlessness, or unwilling to move, medicate sufficiently to allow for deep breathing and shoulder movement

Chest tubes eliminate

air/fluid that has accumulated resulting in a compromise lung function, placed in the pleural space @ the 4th, 5th intercostal space, x-ray confirms proper placement

Chest tube drainage system requires

the pressure within the chest be greater than the pressure within the system

Chest tube components

drainage chamber on the right, water seal chamber in the middle, suction control chamber on the left,

Chest tube inspection look for

redness, swelling, localized pain, purulent drainage

Emergent response for chest tube

have bottle of sterile water & petroleum gauze, assess entire system starting from the insertion site on chest to drainage system

done during deep breath, chest x-ray to inflate lung, observe for signs of pneumothorax

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Stack #239973

Question	Answer
Thoracic surgery is done to	remove tumors, abscessess, resection a segment, lobe or full lung, repair esophagus ot thoracic vessels
Preoperative considerations include	lung function, cardiac function, tumor removal, pain management
Postoperative complications	pain, acute respiratory failure, PNA, other (hemorrhage, mediastinal shift, bronchopleural fistula, CV compromise)
Hemorrhage is life threatening postop	most likely occurs immediately after surgery, causes due to dislodge sutures or clip, bleeding from intercostal/bronchial artery
Potential indicators for hemorrhage	fresh red blood, sudden increase in drainage, drainage volume exceeding 100ml/hour
Bronchopleural fistula indicators	suture line does not hold(compromised by mechanical ventilation & high airway pressures, early weaning is goals), SOB, cough, hemoptysis
Mediastinal shift due to	acumulation of fluid or an increase in pressure on the surgical side, must remove air & fluid on surgical side
CV complications can occur	when large volume of lung tissue & pulmonary vascular bed is resectioned, use vasoactive medications to optimize cardiac function
Indicators of pain to monitor for	tachypnea, tachycardia, elevated BP, grimacing, splinting, moaning, increase restlessness, or unwilling to move, medicate sufficiently to allow for deep breathing and shoulder movement
Chest tubes eliminate	air/fluid that has accumulated resulting in a compromise lung function, placed in the pleural space @ the 4th, 5th intercostal space, x-ray confirms proper placement
Chest tube drainage system requires	the pressure within the chest be greater than the pressure within the system
Chest tube components	drainage chamber on the right, water seal chamber in the middle, suction control chamber on the left,
Chest tube inspection look for	redness, swelling, localized pain, purulent drainage
Emergent response for chest tube	have bottle of sterile water & petroleum gauze, assess entire system starting from the insertion site on chest to drainage system
Chest tube removal	done during deep breath, chest x-ray to inflate lung, observe for signs of pneumothorax

Created by: tauvia2003

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