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 Under a Creative Commons license Open access AbstractBreathing is automatic. We don’t usually think too much about it unless we develop a problem. Lack of adequate ventilation and impairment of our respiratory system can quickly become life-threatening. There are many clinical conditions that may necessitate the use of chest tubes. When there is an accumulation of positive pressure in the chest cavity (where it should normally be negative pressure between pleurae), a patient will require chest drainage. Chest tubes may be inserted to drain body fluids or to facilitate the re-expansion of a lung. It is important for the clinician to determine the most appropriate tube size to use prior to intubation. The position of the chest tube is related to the function that the chest tube performs. When managing the care of patients who have chest tubes it is important to fully understand what to do in case problems arise. It is also important to be able to assess when the chest tube is ready to be discontinued. Nurses and other healthcare professionals who are responsible for the safe delivery of care should be knowledgeable about respiratory pathophysiology, signs of respiratory compromise, and the care and management of interventions that may be utilized to ensure adequate respiration. AbbreviationKeywordsChest tube Chest drainage unit Parietal pleurae Visceral pleurae Cited by (0)Copyright © 2015 The Author. Production and hosting by Elsevier B.V. Copyright © 2018, Elsevier Inc. All rights reserved. Perry: Clinical Nursing Skills & Techniques, 9th Edition A NSWER K EY FOR C HEST T UBES M ODULE P OST T ESTS AND E XAM (Since questions may be reordered with each usage, the question number in the answer key may not correspond to the number that the student reports for a particular quiz item). Lesson 1 Post Test 1. Which of the following tasks associated with a chest tube is the responsibility of the nurse? a) Obtaining informed consent prior to the procedure b) Removing the chest tube when the order is received c) Setting up the equipment, positioning the patient positioning, and monitoring patient status d) Inserting the chest tube, connecting it to a drainage system, and monitoring output Correct answer: c Rationale: The nurse is responsible for assisting during a chest tube insertion. This includes being responsible for setting up equipment, positioning a patient, and monitoring the patient’s status before, during, and after the procedure. It is the responsibility of the physician to obtain informed consent from the patient before inserting a chest tube. The nurse should verify the presence of a signed informed consent document before the start of the procedure. It is the responsibility of the physician or NAP to remove the chest tube. Physicians are usually responsible for the insertion of chest tube catheters. 2. A patient is being prepared for open-heart surgery. Where would you expect the chest tube to be located when the patient returns from surgery? a) In the second or third intercostal space b) In the mediastinum just below the sternum c) In the fifth or sixth intercostal space d) Posteriorly or laterally Correct answer: b Rationale: A mediastinal chest tube is placed in the mediastinum just below the sternum. Mediastinal chest tubes are inserted for open-heart surgery patients to drain fluid away from the pericardial sac. The second or third intercostal space is the common location for a chest tube inserted to resolve a pneumothorax. A chest tube located in the fifth or sixth intercostals space either posteriorly or laterally is the typical placement to remove blood or fluid as with a hemothorax. 3. A student nurse is working as a tutor for a group of freshman physiology students. Which statement, if made by someone in the study group, would require correction? a) “Normally, atmospheric pressure in the pleural space is negative ( -4 to -10 mm Hg).” b) “Besides difficulty breathing, an indication of a tension pneumothorax is a shift of the What are the responsibilities of a nurse to the patient with a chest tube drainage?Nurses' responsibilities when managing a chest drain. Observation of the patient. ... . Observations of the drainage system. ... . Pain management. ... . Suction and chest drains. ... . Clamping drains. ... . Milking and stripping drainage tubing. ... . Changing drainage bottles. ... . Drainage tubing.. What is the nurse's responsibility during chest tube insertion?NURSING ALERT:
Always keep chest drainage system upright and below the level of patient's chest. and attach new drainage system while submerging distal end of chest tube in sterile water. If there are visible clots in tubing, obtain a physician's order to gently “milk” chest tube.
Which of the following is an action the nurse should take if a patient's chest tube accidentally comes out?If the chest tube accidentally falls out, instruct the patient to perform the Valsalva maneuver. At end-expiration immediately cover the insertion site with vaseline gauze (if indicated by your hospital), a dry sterile dressing, and occlusive tape (Pruitt, 2008).
What is a priority when caring for a patient with a chest tube?For treatment of pleural- space disruptions, chest-tube therapy should focus on three primary objectives: - removing air and fluid as promptly as possible - preventing drained air and fluid from returning to the pleural space - restoring negative pressure within the pleural space to reexpand the lung.
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Which of the following are the responsibility of the RN in a client with a chest tube select all that apply?
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