Quote from jchan0425
mr fleming was admitted with multiple injuries following a mva including a haemopneumothorax which required the insertion of 2 chest drains, attached to an uwsd. when caring for mr fleming it is important to know the following:
1. the water in the uwsd tubing should be checked hourly for swinging. in an uwsd system vented to air on inspiration water will rise slightly; on expiration, water will swing down the tube. absence of swinging always means resolution of the pneumothorax.
2. attach a heimlich valve for 24 hours prior to removal to trial patient’s tolerance without the uwsd system.
3. the following s/s signal a medical emergency. shift of the mediastinum to the opposite side, hypotension, severe breathlessness, tachycardia, reduced sao2, increased central venous pressure with distended neck vein and restlessness, pallor and diaphoresis.
4. if the chest drain comes out of the chest, the hole in the chest wall must be covered immediately so that it is air tight to prevent air getting into the pleural cavity.
answer 1) [font=新]wrong, not alwaysmeans a resolution
[font=新]i am choosing number 2 as my answer sounds no mistakes and good
[font=新]what do you think?
look at what the question is asking you.
what is important when caring for this particular patient.
ask yourself, which each question, what action that i take will be the safest, cause harm, consititutes the abcs.
start with question 1. the water swinging. what if it does swing? what if it doesnt'? what does this mean to your pt? it is a priority to know when caring for this pt?
what about 2?
is it important to know about attaching a valve withing 24 hours to determine tolerance? right now? is that important right now? will the pt die if you don't know this now?
what about 3? is it important to know any of this information while caring for this patient?
and 4, do you want a tight seal on that wound if the ct comes out?
and, if the tube comes out, how will you assess your pt for distress?
answering this question is how you answer the orignial question.
this is a no-brainer.