Management and Care of Chest Tubes

The nurse is assessing the functioning of a chest tube drainage system in a client with hemothorax. Which of the following findings should prompt the nurse to notify the physician?

• Fluctuation of water in the tube in the water seal chamber during inhalation and exhalation.
  
  
• Drainage system maintained below the client’s chest
• Drainage amount of 100ml in the drainage collection chamber.
• Occlusive dressing in place over the chest tube insertion site.

Who can remove a chest tube?

• Physician and certified nurses
• Patient
• Patient's family
• Student practical nurse

The nurse is assisting a health care provider with the removal of a chest tube. The nurse should instruct the client to take which action?

• Exhale slowly
• Stay very still
• Inhale and exhale quickly
• Perform the Valsalva maneuver

What does it mean when there is excessive bubbling in the water seal chamber?

• The client has pneumothorax
• The system is functioning normally.
• This can indicate a leak in the system
• The chest tube is obstructed

Patient is admitted to the emergency department with a pneumothorax. Which of the following does the nurse anticipate the patient will be experiencing?

• Dyspnea
• Orthopnea
• Paroxysmal nocturnal dyspnea
• Fremitus

The nurse is working on a pulmonary unit at the local Hospital. The nurse is alert to which of the following as being an early sign of hypoxia?

• Cyanosis
• Restlessness
• Decreased respiratory rate
• Decreased blood pressure

The patient has chest tubes in place after thoracic surgery, what does the nurse need to know about working with a patient who has chest tube?

• The patient has chest tubes in place after thoracic surgery, what does the nurse need to know about working with a patient who has chest tube?
• The tubing should be removed from the connection to check for adequate suction power.
• The tubes should be stripped every 15-30 minutes to maintain drainage.
• Periodic lifting and drainage of coiled loop will promote pleural drainage.

What is the purpose of the fluid in the pleural cavity?

• Lubricate the pleural surfaces to allow them to glide painlessly during lung expansion and contraction.   
• Warm and moisten lung tissue
• Preventing bacteria from entering lung tissue
• Assist in the diffusion of oxygen across the respiratory membrane

A client is diagnosed with a spontaneous pneumothorax necessitating the insertion of a chest tube. What is the best explanation for the nurse to provide this client? 

• “The tube will drain fluid from your chest.”
• “The tube will remove excess air from your chest.”
• “The tube controls the amount of air that enters your chest.”
• “The tube will seal the hole in your lung.”

What is included in the Respiratory Assessment for prior to chest tube drainage and before removing the chest tube? 

• RR & O2 SAT for baseline
• Tachypnea, Hypoxia - Respiratory Distress
• Lung sounds & Pain
• All choices are correct