25.     Define pneumothorax. 26.     Define hemothorax. 27.     Define empyema. 28.     What is a chest tube? Describe 2 reasons for its use. 29.     What are the two sites used for inserting a chest tube? 30.     What is water-seal suction? What is the purpose? 31 . What are the nursing responsibilities for managing the care of a client who has a chest tube drainage system? 32.     What is the purpose of adding suction to the chest tube drainage system? 33.     What is an air leak?

25. Pneumothorax is a medical condition characterized by the presence of air or gas in the pleural space, which is the area between the lung and the chest wall. This can occur due to a variety of reasons, such as trauma, spontaneous rupture of small air-filled sacs called blebs on the lung surface, or as a complication of medical procedures. The presence of air in the pleural space can lead to the collapse of the lung, resulting in respiratory distress and reduced oxygenation.

26. Hemothorax is a condition in which there is blood accumulation in the pleural space. It usually occurs as a result of trauma, such as a chest injury or a ruptured blood vessel in the lung tissue. The presence of blood in the pleural space can cause compression of the lung, leading to respiratory compromise and potential hemodynamic instability.

27. Empyema refers to the accumulation of pus in the pleural space. It typically occurs as a complication of a lung infection, such as pneumonia, where the infection spreads to the pleural space. The presence of pus in the pleural space can lead to inflammation, scarring, and impaired lung function.

28. A chest tube, also known as a thoracostomy tube, is a medical device inserted into the chest to drain air, fluid, or pus from the pleural space. It consists of a hollow tube connected to a drainage system. The chest tube is inserted through a small incision in the chest wall under sterile conditions and is secured in place.

There are several reasons for using a chest tube. One reason is to treat a pneumothorax by allowing the trapped air to escape and the lung to re-expand. Another reason is to drain a hemothorax or empyema by removing the accumulated blood or pus from the pleural space. The chest tube provides a direct route for the drainage and helps alleviate the respiratory and hemodynamic impairments associated with these conditions.

29. There are two common sites for inserting a chest tube: the anterior (front) and lateral (side) aspects of the chest. The specific site chosen depends on factors such as the underlying condition being treated and the surgeon’s preference. The anterior site is often used for pneumothorax, while the lateral site is commonly used for hemothorax or empyema.

30. Water-seal suction is a technique used to create a negative pressure within the chest tube drainage system. This is accomplished by connecting the chest tube to a collection chamber containing sterile water, which acts as a seal. As the patient breathes, excess air or fluid is removed from the pleural space and passes through the chest tube. The water-seal suction helps maintain the integrity of the drainage system and prevents air or fluid from re-entering the pleural space.

The purpose of water-seal suction is to promote lung re-expansion, eliminate air or fluid from the pleural space, and prevent the accumulation of excess fluid or air. It also allows healthcare providers to monitor the amount and characteristics of the drainage, which can provide valuable diagnostic information.

31. Managing the care of a client with a chest tube drainage system involves several nursing responsibilities. These include:

– Assessing the patient’s vital signs, respiratory status, and pain level regularly.
– Monitoring the chest tube insertion site for signs of infection or complications.
– Ensuring proper functioning of the chest tube drainage system and maintaining the water-seal suction.
– Managing the collection and disposal of drainage appropriately.
– Assisting with patient mobility and positioning to optimize lung drainage and prevent complications.
– Providing education to the patient and their caregivers about the purpose of the chest tube, signs of complications to watch for, and how to care for the insertion site.

32. The purpose of adding suction to the chest tube drainage system is to enhance the removal of air or fluid from the pleural space. By creating a negative pressure, suction helps to improve drainage efficiency and promotes lung re-expansion. This is particularly important in cases of significant pneumothorax, hemothorax, or empyema, where there is a large volume of air or fluid that needs to be evacuated.

33. An air leak refers to the unintended escape of air from the pleural space into the chest tube drainage system. It can occur due to various reasons, such as incomplete lung re-expansion, poor chest tube placement, or a defect in the lung tissue. An air leak can be detected by observing continuous bubbling in the water-seal chamber of the drainage system. It is essential to identify and address air leaks promptly, as they can interfere with proper lung re-expansion and affect the effectiveness of the chest tube drainage.