NURSING MANAGEMENT OF PATIENTS WITH CHEST DRAINS Chest drains are one-way draining medical devices that allow fluid or air accumulations to be drained from the chest cavity. Normally the chest drains are inserted following an x-ray report that confirms the presence of air or fluid in the chest cavity. The rationale for the chest drain insertion is that the drain will help restore the normal function of the lungs, by allowing the drainage of the air or fluid collected in the pleural space. There are a number of indications for drains insertions such as: pneumothorax, pleura effusions, haemothorax or post cardio-thoracic surgery. To understand completely the importance of inserting chest drains, when required, we have to look closely at the entire mechanism of breathing.
How to wash your hands Washing your hands properly is an easy way to avoid getting and spreading viruses and germs. First, remove all rings, watches, bracelets, or other jewelry on hands and wrists. Jewelry can carry pathogens and should be cleaned with a disinfectant separately, so they will not be damaged. Next, stand close enough to the sink to reach the flow of water without touching the sink with your body because the sink itself should be considered contaminated. By standing too close to the sink it may spread any contamination to your cloths.
Nasogastric tube also bypasses the lower esophageal sphincter and permits reflux. Dry mucous membranes and thick secretions is another complication. This is seen in patients with extended use of noninvasive ventilation. To prevent this from occurring, humidification for noninvasive ventilation devices should be provided along with daily oral care. Another complication that occurs is aspiration of gastric contents, especially if emesis occurs during noninvasive ventilation.
It can lead to complications. Atrial fibrillation may lead to blood clots forming in the heart that may circulate to other organs and lead to blocked blood flow (ischemia)” The danger of this disorder is that the heart may not be able to pump enough blood to support the functioning of the body. There are some patients who will have some, all, or no symptoms at all. Some symptoms include: • “Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a flip-flopping in your chest • Weakness • Reduced ability to exercise • Fatigue • Lightheadedness • Dizziness • Confusion • Shortness of breath • Chest pain Atrial fibrillation may be: • Occasional. In this case it's called paroxysmal (par-ok-SIZ-mul) atrial fibrillation.
Life support may begin with basic CPR. Subsequently, the most common technique to secure an airway is by the insertion of an endotracheal (ET) tube through the mouth or nose into the windpipe. If an ET airway cannot be established then a tracheotomy is performed, which is a surgical procedure in which a tube is inserted into the windpipe through an incision made in the base of the throat (Berniker). When the patient cannot breathe sufficiently on his or her own, the physician will use a ventilator, a machine that pumps air in and out of the patient’s lungs to aid in respiration. Circulation refers to the flow of blood around the body from the heart to vital organs.
The bag is then inflated until the air pressure in the cuff overcomes the arterial pressure and obliterates the arterial lumen. This is confirmed by palpating the radial pulse that disappears when the cuff-pressure is raised above the arterial pressure. The pressure is then raised further by 20 mm Hg and then slowly reduced. When the pressure in the cuff reaches just below the arterial pressure, blood escapes beyond the occlusion in to the peripheral part of the artery and the pulse starts reappearing. This is detected by the appearance of sound heard in the stethoscope and pressure at which the sounds are first heard is the systolic pressure.
Administer paracetamol and non-opioid analgesia for relief of muscle pain. 12. Continuous monitoring is required for 72 hours or longer as organophosphate may be intermittently released from fat stores with ECG, arterial BP monitoring, SpO2, CVC access, CXR. 13. Observe for deterioration post-reduction of drug therapies, auscultate lung bases for crackles.
In some cases gallstones may be removed to relieve blockage of the pancreatic duct. In the most severe cases, surgery is needed to remove dead or infected pancreatic tissue. Complications from acute pancreatitis include acute kidney failure, ARDS, ascites, Cysts or abscesses in the pancreas, and heart failure. Repeat episodes can lead to chronic pancreatitis. References Bare, B.G., Cheever, K.H., Hinkle, J.L., & Smeltzer, S.C. (2008).
Infections can also be transferred through visitors coming in to see their relatives. MRSA, Influenza, E coli are common causes of infections and can't all be treated by antibiotics. Some infections are resilient to them and they don't work. It is also known that Scabies is a well known infection in nursing homes and can be treated but can spread very quickly so needs to be picked up quickly, and should be isolated for 24hrs after treatment. Treatment should be repeated in about 4 weeks time and all clothes, towels etc.
For all sterilising equipment, follow the manufacturer’s instructions. Cold water sterilisers need the solution changing every 24 hours, and feeding equipment needs to be left submerged for 30 minutes before it can be used. Make sure there are no trapped air bubbles in the bottles or teats, as this means these areas won’t be sterilized. Ensure all the equipment is kept under the water with a floating cover. When using a steam sterilizer, make sure that the teats and bottles are facing down, so that the steam goes up into them when the water heats up.