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Lindsey Jones 3A5
Lindsey Jones 3A5 Therapeutics: Humidity&Aerosol Therapy B)Chest tubes&Drainage
| Question | Answer |
|---|---|
| What are 2 types of therapeutic aids to ventilation? | 1. Humidity and Aerosol therapy and 2. Chest tubes and drainage systems. |
| What is Humidity therapy? | Non particle-size water that is distriuted uniformly in the air. |
| What happens to normal humidity when environment differs? | Enviornments differ in their normal humidity (20%, 50%, 70% etc.) but the body always needs 100% humidity. |
| What is Humidity deficit? | It is the amount of water (humidity) the body needs to makeup from ambient air in order to achieve 100%. It is expressed as mmgH20/L of gas. The body needs 44 mg H20/L of gas. |
| When does devices intended to help humidity deficit work better? | 1. Temperature is increased. 2. Surface area of the water is increased. 3. Pressure in the system is decreased. |
| What is the problem with humidity devices? | It can be a source of contamination. |
| What is areosol therapy/ the aerosol particles? | aerosol particles are larger particles, can often been seen visually. May be made of water, liquid medication, or dry powder-type medication. |
| What does an aerosol therapy cause to the patient? | Aerosols are not natural to the airways and may cause irritation, bronchospasm. |
| What are the optimal particle sizes in aerosol therapy? | Large airways -particles >5 microns.Middle&small airways is 3-5 microns. Alveoli-particle s >0.5 microns & < 3 microns. |
| What happens when there is a particle deposition in an aerosol therpay? | The higher the flow rate, the higher up the resp. tract the deposition will occur.The Inspiratory hold will increase particle deposition |
| What are the general goals of aerosol therpay? | goals: delivered medications- Bronchodilators, Mucolytics (secretions thining agents), Provides mucosa hydration & delivered antibiotic medications. |
| What are the complications and hazards of Aerosol therapy? | 1. Fluid overload (monitor input/output) 2. Bronchospasm 3. Contamination 4. Ultrasonic Nebulizers should not be used to for medications 5. Dizziness may result if a pt. over-ventilates -Have pt. slow down &Use normal breathing pattern |
| How do we monitor an aerosol output? | 1.If no output - check medications, fluid level, device for proper function - Commonly need to increase the flow 2. If aerosol doesn't disappear during an inhalation, instruct pt. to breath thru mouth - Not thru Nose |
| What are the indiccations for a chest-tube insertion? | Pneumothorax -Air &Hemothorax -Fluid &Air in pleural space causing lung collapse.If > 20% of lung need a chest tube(CT) based on X-ray &BS.Pleural Effusion -Excess Fluid causes Lung Spaceloss treat by inserting needle in space to relievepressure;insert CT |
| What is a chest tube insertion procedure? | 1.Pneumothorax -Tube placed in upper chest, 2nd interspace, midclavicular line. 2.Hemothorax/Pleural effusion tube placed b/w 4th &5th interspace, midaxillary line. |
| What conditions must exists when removing/discontinuing a chest tube? | Tube must be clamped for 24hrs. In that 24hrs they must not be :1. Any sign of Resp. distress 2. Any evidence of Pnuemothorax/Hemothorax as indicated by X-ray. 3. If these exists, unclamped the chest tube &Resume chest drainage. |
| Whati s a chest tube removal procedure? | 1. Pull the Tube during a Valsalva Manuever after complete exhalation 2. The side should be covered with petroleum based Jelly &Sterile gauze. 3. Pulse X-ray should be taken |
| What are the type of chest drainage system? | They consist of a single/Series of glass bottles/ Jugs. It is helpful for Visualization purpose, to consider the older type of system in order to increase/understanding on how these systems functions. |
| What are the functions of a chest drainage system? | 1. Collection of fluids. 2. Control suction 3. Allow 1-way movement of gases &Fluids(out of lung, not back in). This is called a Water seal. |
| What are the types of chest drainage systems? | The 3 bottle systems (1-bottle, 2-bottle, 3-bottle). |
| What is the 3 bottle system? | From pt. a tube E enters a collection bottle. Fluid drops to bottom &gas is pulled in other tube. TubeD enters water seal bottle gases are drawn thru a tube. i.e Submerged under H2O(Gentle bubbling is seen). TubeC enters suction control bottle no bubbling |
| What is the disposable system ? | Used in 3 bottle system. 1.Suction Control 2.Water Seal 3.Collection bottle. When Collection chamber is full replace whole unit. 1-2cm H2O should be placed in Water seal bottle. 15-20cm H2O should be placed in suction control bottle |
| What are the potential problems while there is a low return volume in a mech. Vent found during monitioring a chest drainage system? | low return volume in a mech. Vent - It means lost volume thru the lung & the Chest Tube. 1. Adjust VT to maintain desired ABG values. 2.Hole in the Lung may need surgical repair. |
| What are the potential problems when there is no bubbling in the suction control bottle found during monitioring a chest drainage system? | Increase vaccum pressure @ the Wall source until bubbling occurs. |
| What are the potential problems when excessive bubbling in the suction control bottle found during monitioring a chest drainage system? | Decrease until only gentle bubbling is present. |
| What are the potential problems when excessive/continous bubbling found during monitioring a chest drainage system? | 1. Indicates a leak b/w pt.&water-seal bottle. 2. If all connections are secure-begin unclamping tube E where the tube exists the pt. If bubbling stops then leak is inside the pt.& surgery is needed. |
| If bubbling continues what is to be done? | If bubbling continues move clamp b/w pt & collection tube. If bubbling stops-replace tube.If bubbling continues move clamp to tubing b/w collection & water-seal bottle. If bubbling stops-replace tubing. Bubbling should stop if not, replace external system |
| What are the potential problems when nothing developing in the collection bottle - lung is not re-inflating found during monitioring a chest drainage system? | 1. Ensure there is suction coming from the wall. 2. Ensure bottle system is below insertion site of chest tube. *sometimes systems use gravity alone. There is no vaccum. These systems work fine. Vaccum only assist evacuation. |
| What are the potential problems No bubbling in the water-seal bottle found during monitioring a chest drainage system? | Suction is not enough -not enough water in the suction control bottle. |
| What are the potential problemscollection bottle is developing fluid quickly @ >100 ml/hr found during monitioring a chest drainage system? | 1. Pt. may be hemorrhaging. 2. Evaluate: Hb, Bp, vitals and all data associated w/blood loss. |
| What should be done if a glass bottle breaks during monitioring a chest drainage system? | If glass bottle breaks then submerge chest tube into water from any container. |
Created by:
johnfaar
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