Chapter 28
Respiratory Care
589
• CPT helps loosen and drain mucus from all the lobes of the lungs. • Supplemental oxygen is available from different sources and with a variety of delivery devices. All require use of stringent safety precautions to prevent fi re. • The patient with chronic lung disease needs to conserve energy and preserve accessory muscles for breathing. • Arti fi cial airways vary from small plastic devices inserted in the mouth to tubes inserted through the nose, mouth, or an incision into the trachea. • When caring for patients with arti fi cial airways, you will suction to keep them patent. For tracheostomies, you will remove the inner cannula to clean or replace it. • Chest tubes are inserted to reestablish intrathoracic pres- sure, remove air and drainage, and rein fl ate the lung. CRITICAL THINKING EXERCISES Answers available online. 1. Your patient had a chest tube inserted yesterday to drain a hemothorax and has been doing well. Suddenly the patient becomes restless and agitated, and respirations become more labored. When you take vital signs, you find the BP has dropped to 96/60, pulse is up to 110, and
• There are two types of chest tube drainage systems. The three-chamber system contains one chamber for suction, one chamber to create a water seal, and one chamber to collect drainage. Digital drainage systems contain all the drainage in one replaceable container and give digital readouts about air leaks and the amount of drainage. • You are responsible for marking output for your shift, keeping the drainage unit upright and below the level of the chest, and keeping the tubing free from kinks and loops. • You must know how to troubleshoot air leaks and what to do if the chest tube accidentally comes out or becomes disconnected from the closed drainage system.
respirations are increased to 26 per minute. What will you do next? 2. Your patient with a tracheostomy is on a ventilator. His neck looks swollen this morning, and it has not been that way previously. What are your concerns?
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