Assignment Task:
C.K. is a 65 year old male with COPD who was admitted to the hospital with community acquired pneumonia (CAP). Today he developed new onset confusion, chest pain and increased shortness of breath (SOB). You are the ICU NP consulted on this patient. When you walk into the patient's room you see a thin gentleman who is trying to get out of bed, pulling off his nasal cannula and has labored breathing.
The patient was admitted yesterday with CAP and given IV Levofloxacin and IV methylprednisolone. He was calm, oriented and doing well on 2 L nasal cannula oxygen maintaining Sp02 97%. Around 5am the patient pulled out his IV and attempted to get out of bed. He stated he couldn't breathe.
Vital signs: temperature: 100.2F, Heart rate 128, BP 180/102, Sp02 72%--> you placed the nasal cannula back on the patient and Sp02 increased to 88%
Pertinent positives/negatives from ROS: (+) SOB (+) cyanosis to distal finger tips and toes (+), (+) sharp chest pain (-) palpitations.
PE:
Gen: Thin male in distress
HEENT: tracheal deviation to the left
CV: tachycardic, regular, II/IV grade systolic ejection murmur
Pulm: tympanic over right upper lobe, auscultation- mid-late expiratory wheeze in left lung and distant breath sounds in the right upper lobe.
GI: abdomen flat, no pain on palpation, (+) bowel sounds
GU: deferred d/t resp distress
Musculoskeletal: full ROM, hand grips 5/5 bilaterally, rest of exam deferred d/t respiratory distress
Neuro: alert, oriented to place, disoriented to time. PERRLA; rest of exam deferred d/t respiratory distress
This patient needs a chest tube.
Questions
Where should a chest tube be placed for a pneumothorax? Need Assignment Help?
Should this chest tube be water seal or suction?
Explain the difference?
And why did you choose this.
Question
There are currently 3 different types of pleural drainage systems on the market: Dry dry, Dry-wet, wet-wet, explain the difference between these 3 drainage systems?