Module 1: Respiratory Disorders- Pleural and Thoracic Injury
Marnie Quick, RN, MSN, CNRN
1. Differentiate the following:
Pathophysiology Manifestations Treatment
2. If over 1500ml of fluid is removed by thoracentesis, what can
3. What is be your assessment and care during & post thoracentesis?
4. Differentiate the types of pneumothorax:
Type Pathophysiology Manifestations Treatment
5. Why is a tension pneumothorax a medical emergency, what happens
and what can be done about it?
6. How does a chest tube with closed drainage system restore intra
pleural negative pressure in the pleural space?
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7. Utilizing the picture on p. 1148, label and state the purpose of each of
the 3 chambers in the closed chest tube drainage system.
8. Does the closed chest tube drainage system need to always be
connected to suction? Then how can it drain?
9. What is the purpose of an air vent in the closed chest drainage
10. How do you set up the Pleur-evac system? How does it work?
11. You are caring for a patient with a chest tube to closed drainage
system, what do you do if:
a. Collection chamber becomes full?
b. Over 100 ml/hr of drainage is noted?
c. You have an order to walk your patient who’s connected to
d. You see ‘tidaling’ in the water seal chamber- what if it stops?
e. You observe constant bubbling in the water seal chamber?
f. The pleur-evac is stepped on and cracks?
g. What patient teaching is needed when the physician plans to
remove the chest tube?
12. The chest tube for a pneumothrax is generally placed higher or lower
than a chest tube for a hemothorax. Why?
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Pathophysiology Manifestations Treatment Complications
14. Why would positive-pressure ventilator be utilized for flail chest?
15. Explain to your patient with a thoracic injury how’s and why’s of
16. Describe the assessment needed for a patient with thoracic injury.
17. What are potential complications of thoracic injury?
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