Generally credentials are listed from most to least permanent. A degree, once earned, cannot, in normal circumstances, be taken away. State licensure is only revoked for differential diagnosis for the advanced practice nurse pdf professional misconduct.
Nurses may also hold non-nursing credentials including academic degrees. These are usually omitted unless they are related to the nurse’s job. In this role, he or she may never see another patient except while doing hospital inspections, or perhaps talking to a patient or the patient’s family about a quality of care concern. In this role, the nurse becomes something similar to an auditor and a teacher of patient care quality and risk for the entire hospital staff.
This nurse likely will also get the certification listed below: CPHQ: Certified Professional in Healthcare Quality. Also, some hospitals may require certain nurses, such as nursing supervisors or lead nurses, be certified. Certification instills confidence in the nurses. This page was last edited on 10 November 2017, at 16:25.
Chest tubes are used to treat conditions that disrupt the pleural space. Chest Tube Care, Management and Troubleshooting patients with chest tubes. Start your subscription today and never miss an issue. Once you understand the basics, you can be confident when caring for patients who have chest tubes. The practice of using a cannula to drain air or fluid from the pleural space dates back to antiquity. It’s one element in the trinity of life-saving medical procedures.
The others are endotracheal intubation and venous cannulation. Hippocrates and Celsus recorded using hollow tubes to drain loculated empyemas. By the 1800s, catheters frequently were used to drain and irrigate empyematous cavities. A brief review of pulmonary anatomy and physiology helps you understand where chest tubes are placed and how they work. Chest tubes aren’t placed in the lungs but in the pleural space—a potential rather than actual space between the parietal and visceral pleurae. But when you try to separate them, they stick together.
The ability to adhere creates negative pressure within the pleural space, which becomes more negative as the visceral and parietal pleurae are pulled in opposite directions during inspiration. Picture those two glass plates. Expiration increases intrapleural and intrapulmonary pressures to the point where they exceed atmospheric pressure, creating an opposite pressure differential and causing air to flow out of the lungs into the surrounding atmosphere. A breach in pleural integrity creates a separation between the parietal and visceral pleurae, allowing air or fluid to fill this potential space. The visceral pleura collapses inward along with the lungs, while the parietal pleura recoils outward along with the chest wall.
The body can absorb small volumes of fluid or air over time. But larger volumes limit lung expansion, causing respiratory distress. In extreme cases, a tension pneumothorax may develop. This condition occurs when injured tissue forms a one-way valve or flap, enabling air to enter the pleural space and preventing it from escaping naturally. Seen mainly with thoracic trauma and line placement, this condition rapidly progresses to respiratory insufficiency, cardiovascular collapse, and ultimately death if unrecognized and untreated. Chest tubes also may be used to prevent or mitigate postoperative complications.