N-NF-II-125 Chapter Notes - Chapter 7: Chest Tube, Pleural Effusion, Hemothorax

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bsm5622

30 Oct 2022

School

Kerala University of Health Sciences - KUHS

Department

Nursing

Course

N-NF-II-125

Professor

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Document Summary

If the thin, double-layered pleural membrane is disrupted by lung disease, surgery, or trauma, the negative pressure between the pleural layers may be lost. The lung then collapses because it is no longer drawn outward as the diaphragm and intercostal muscles contract during inhalation. When air collects in the pleural space, it is known as a pneumothorax. A haemothorax is the accumulation of blood in the pleural space, and a pleural effusion exists when there is excessive fluid in the pleural space. The air, blood, or fluid in the pleural space places pressure on lung tissue and interferes with lung expansion. Chest tubes may be inserted into the pleural cavity to restore negative pressure and drain collected fluid or blood. Because air rises, chest tubes for pneumothorax often are placed in the upper anterior thorax, whereas chest tubes used to drain blood and fluid generally are placed in the lower lateral chest wall.

Related Questions

Do any of these instructional notes apply to this scenario?

EXCLUDES: Lung removal with bronchoplasty (32501)

Code also decortication (32320)

Code also excision of chest wall tumor, when performed (21601-21603)

Documentation:

PREOPERATIVE DIAGNOSIS: Mass of lung

POSTOPERATIVE DIAGNOSIS: Carcinoma of the right lung

OPERATION PERFORMED: Bronchoscopy and right upper lobectomy

The patient was brought into the operating room, and after the

administration of anesthesia, the patient was prepped and draped in the usual sterile fashion. The patient was placed in the left lateral decubitus

position. A thoracotomy incision was made. This exposed the chest

muscles, which were incised and retracted. The fourth and fifth ribs were

visualized and transected to allow entrance to the chest. A tumor mass was

noted. This mass measured 7.0 cm in diameter, involving the right lung

upper lobe. The mass was excised in its entirety, and a biopsy of the mass

was taken and sent for frozen section. The frozen section revealed

squamous cell carcinoma. Nodes were then dissected around the pulmonary

artery and the trachea. The nodes were sent for frozen section. The nodes

were identified as negative per pathology. Saline was irrigated into the

chest. It was noted that the liver and diaphragm appeared to be normal with

no lesions seen. After verification that the sponge count was correct, chest

tubes were placed for drainage. The surgical wound was closed in layers

with chromic catgut and nylon. The patient tolerated this portion of the

procedure well.

The patient was then placed in the supine position for the bronchoscopy.

The patient was still under anesthesia. A flexible fiberoptic bronchoscope

was inserted. Patient bronchi were noted bilaterally. The scope was

withdrawn. The patient was awakened and sent to the recovery area in

stable condition.

a. Yes

b. No

StewartRenee

Which of these first modifying term(s) apply to the scenario? (Check all

that apply.)