Chest Drainage CEU 509

A potentially life-threatening condition in which blood collects around the heart, particularly after heart surgery or chest trauma is called A. Cardiac tamponade B. Mediastinal effusion C. Mediastinal shift D. Cardiac insufficiency

A. Cardiac tamponade

A physician has just performed a thoracostomy for a pleural effusion. The nurse handed the patient tubing from the drain to the physician who attached it to the chest tube. The drain is properly filled with water and placed in an upright position below the patient's chest. The physician orders suction to the chest drain system. The nurse should adjust the vacuum source until A. Constant, gentle bubbling just begins in the suction control chamber B. There is vigorous bubbling in the suction control chamber C. The dial on the vacuum regulator reads - 20 mmHg D. There is bubbling in the water seal chamber

A. Constant, gentle bubbling just begins in the suction control chamber

A patient with an opening in the chest wall, such as from a gunshot, stab wound or impalement, resulting in a "sucking chest wound" can be said to have A. Open pneumothorax B. Hemothorax C. Closed pneumothorax D. Pleural effusion

A. Open pneumothorax

Which statement is true regarding patient movement while requiring chest drainage? (Assume a physician order or protocol exists.) A. Patients may walk around once the nurse disconnects the drain from suction as long as the drain remains below the chest. B. Patients may go only from bed to a chair while the chest tube is connected to a chest drain. C. When the patient is ambulatory, the suction tubing must be occluded or the stopcock closed while the drain is disconnected from the vacuum regulator. D. If the patient must leave the nursing unit, the suction tubing must be clamped while the chest drain is disconnected from suction.

A. Patients may walk around once the nurse disconnects the drain from suction as long as the drain remains below the chest.

A potentially life-threatening condition in which air and pressure rapidly accumulate in the pleural space and, if not treated, can result in a mediastinal shift, is called A. An iatrogenic pneumothorax B. A tension pneumothorax C. An open pneumothorax D. A spontaneous pneumothorax

B. A tension pneumothorax

Which statement best describes autotransfusion in patients requiring a chest tube? A. Blood is removed from the chest drain, washed, and given to the patient via IV infusion B. Blood is removed from the chest drain and immediately given to the patient via IV infusion C. Blood is removed from the chest tube and immediately given to the patient via IV infusion D. Blood is removed from the chest drain and stored in the blood bank until the patient needs the transfusion

B. Blood is removed from the chest drain and immediately given to the patient via IV infusion

Which of the following signs indicates a chest tube may be removed? A. Drainage is approximately 100 mL/hr in a patient with mediastinal chest tubes following heart surgery B. Bubbling in the water seal has been absent for 24 hours following iatrogenic pneumothorax from CVP placement C. The chest radiograph shows only a small residual pneumothorax in a patient requiring mechanical ventilation D. Fluctuations in the water seal are approximately 2 to 4 cmH20 with each breathing cycle

B. Bubbling in the water seal has been absent for 24 hours following iatrogenic pneumothorax from CVP placement

The anatomical structure located in the center of the thoracic cavity is the A. Visceral pleura B. Mediastinum C. Parietal pleura d. Diaphragm

B. Mediastinum

New bubbling is observed in the water seal chamber after a patient with a pleural chest tube returns from radiology. The nurse clamps the chest tube momentarily with a tubing clamp at the dressing site. When this is done, bubbling in the water seal stops. The next appropriate nursing action is to A. Do nothing. This bubbling is normal in patients with pleural chest tubes B. Remove the chest tube dressing to see if one or more eyelets of the chest tube have been pulled out of the chest C. Call the physician STAT and remain at the patient's bedside because of the risk of imminent respiratory failure D. Continue to monitor the water seal chamber for bubbling every hour for the next four hours

B. Remove the chest tube dressing to see if one or more eyelets of the chest tube have been pulled out of the chest

If bubbling in the water-filled suction control chamber is too vigorous A. Water will not evaporate from the chamber B. The noise may be very disturbing to the patient and others nearby C. The water level will rise, imposing a higher level of suction than desired D. Fluid drainage from the chest will be impaired

B. The noise may be very disturbing to the patient and others nearby

Which of the following situations is likely to result in an absence of tidalling in the water seal chamber? A. The patient is receiving positive pressure ventilation B. The tubing is blocked in some way C. The tubing is coiled on the bed with a straight path to the chest drain D. The patient is ambulatory

B. The tubing is blocked in some way

In self-contained, disposable chest drains, the manual high negative pressure relief valve A. Alerts the nurse to a situation of high pressure within the system and automatically vents B. Allows water to be added to the system without disconnecting the patient tubing C. Allows filtered atmospheric air into the system to offset a rise in negative pressure D. Alerts the nurse to high suction levels accumulating in the system

C. Allows filtered atmospheric air into the system to offset a rise in negative pressure

Which of the following statements is true about intrapleural pressure under normal conditions? A. It is negative during inhalation; positive during exhalation B. It is always positive C. It is always negative D. It is positive during inhalation; negative during exhalation

C. It is always negative

The most important element of a chest drainage system is the A. Suction control B. Collection bottle / chamber C. Water seal D. Suction source

C. Water seal

If the chest tube is pulled out of the patient's chest, and the patient had bubbling in the water seal, after asking a colleague to call a physician STAT, emergency nursing management is to A. Leave the opening alone and monitor the patient carefully until the physician arrives B. Try to put the tube back in place as quickly as possible C. Cover the opening with a sterile Vaseline gauze, taped securely on all sides D. Cover the opening with a sterile dressing, taped on three sides

D. Cover the opening with a sterile dressing, taped on three sides

In a self-contained, disposable chest drain, the amount of negative pressure transmitted to the patient by suction is determined by A. The sensitivity of the high negative pressure relief valve B. The suction level set on the wall vacuum regulator C. The level of water in the water seal chamber D. The level of water or the dial setting on the suction control chamber

D. The level of water or the dial setting on the suction control chamber

When is it beneficial to clamp a chest tube? A. Whenever the patient leaves the nursing unit and cannot be monitored B. When ambulating a postoperative patient with a chest tube C. It is never beneficial to clamp a chest tube D. To simulate tube removal and assess the patient's response

D. To simulate tube removal and assess the patient's response