Stack #239973
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| Thoracic surgery is done to | remove tumors, abscessess, resection a segment, lobe or full lung, repair esophagus ot thoracic vessels
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| Preoperative considerations include | lung function, cardiac function, tumor removal, pain management
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| Postoperative complications | pain, acute respiratory failure, PNA, other (hemorrhage, mediastinal shift, bronchopleural fistula, CV compromise)
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| Hemorrhage is life threatening postop | most likely occurs immediately after surgery, causes due to dislodge sutures or clip, bleeding from intercostal/bronchial artery
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| Potential indicators for hemorrhage | fresh red blood, sudden increase in drainage, drainage volume exceeding 100ml/hour
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| Bronchopleural fistula indicators | suture line does not hold(compromised by mechanical ventilation & high airway pressures, early weaning is goals), SOB, cough, hemoptysis
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| Mediastinal shift due to | acumulation of fluid or an increase in pressure on the surgical side, must remove air & fluid on surgical side
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| CV complications can occur | when large volume of lung tissue & pulmonary vascular bed is resectioned, use vasoactive medications to optimize cardiac function
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| 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
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| 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
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| Chest tube drainage system requires | the pressure within the chest be greater than the pressure within the system
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| Chest tube components | drainage chamber on the right, water seal chamber in the middle, suction control chamber on the left,
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| Chest tube inspection look for | redness, swelling, localized pain, purulent drainage
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| 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
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| Chest tube removal | done during deep breath, chest x-ray to inflate lung, observe for signs of pneumothorax
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Created by:
tauvia2003