am i correct on this UWSD question

[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) wrong, not alwaysmeans a resolution

i am choosing number 2 as my answer sounds no mistakes and good

what do you think?

[Silverdragon102, BSN]

You are asking a lot of questions are you studying for anything specific?

[cardiacRN2006, ADN, RN]

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) wrong, not alwaysmeans a resolution

i am choosing number 2 as my answer sounds no mistakes and good

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.

[jchan0425]

You are asking a lot of questions are you studying for anything specific?

not anything specific just nursing

i am doing a RN course but what they are teaching is a post-graduate diploma ICU course content.

we don't know the basic, how can we do the advance? They teach UWSD but never show us a real one even a bloody video, instead showing a empty bottle and tell us the mechnism of it... that's why i have a lot of questions

i am sorry if i am making any trouble

[cardiacRN2006, ADN, RN]

Chest tubes, and the assessment thereof is not limited to ICU content. Many tele units have chest tubes.

Look at the question. It asks, what is important to know.

Well, what is important to know when caring for a chest tube? Answer 1 and 2 aren't as important as what to do if things go bad. Look at answer 3. Is it important to know what the s/s of a tension pneumothorax are? I alluded to it in my first response.

What is the most important thing to do here? It's to know if your pt is having a medical emergency R/T her chest tube. It's to be able to asses this, anticipate this, prepare for this, and prevent this.

That's what nursing is all about.

[Silverdragon102, BSN]

not anything specific just nursing

i am doing a RN course but what they are teaching is a post-graduate diploma ICU course content.

we don't know the basic, how can we do the advance? They teach UWSD but never show us a real one even a bloody video, instead showing a empty bottle and tell us the mechnism of it... that's why i have a lot of questions

i am sorry if i am making any trouble

You are not making trouble but would help if you explain a bit more and also give your thoughts on the question being asked. We see lots of people ask homework questions without explaining and giving their thoughts on the question. Almost as if expecting the membership to do their homework for them

Just nice to know a bit more

[jchan0425]

You are not making trouble but would help if you explain a bit more and also give your thoughts on the question being asked. We see lots of people ask homework questions without explaining and giving their thoughts on the question. Almost as if expecting the membership to do their homework for them

Just nice to know a bit more

ok cool, i will give some more own opinion next time rather than leaving the question here coz that's what we usually do in skool forum.

[3101]

tee hee, busted, I'm in this class too,

here's a few things to think about:

the word 'always' in the first option, it bothers me, there could be other reasons for this (think occlusion, kinking etc)

look up a heimlich valve and see how it is used/ what it is used for

third one, do those things signal a medical emergency, how would they be related to an UWSD?

do you want an airtight seal? what is an UWSD used for? Is an UWSD airtight? what would be the result of using an airtight seal.

Cheerio, hope you do well in the assignment but I would suggest that the discussion forums for the topic would be a more appropriate place to ask questions. I am not convinced that UWSDs are postgraduate material, this question requires only the most basic knowledge of an UWSD which will be useful in many different wards from medical to cardiothorasic.