A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take?
A.
Disconnect the chest tube from the drainage system during transport.
B.
Empty the collection chamber prior to transport.
C.
Clamp the chest tube prior to transferring the client to a wheelchair.
D.
Keep the drainage system below the level of the client’s chest at all times.
The Correct Answer and Explanation is:
The correct answer is D. Keep the drainage system below the level of the client’s chest at all times.
Explanation:
A chest tube is used to remove air, blood, or fluid from the pleural space to help re-expand the lung and restore normal breathing. The chest tube is connected to a closed drainage system that uses gravity or suction to assist in this process. It is essential to maintain the functionality and safety of this system, especially when transporting a client.
Why option D is correct:
The drainage system should always be kept below the level of the client’s chest to facilitate the drainage of air or fluid and to prevent backflow into the pleural space. This prevents reaccumulation of fluid or air, which could cause a pneumothorax or pleural effusion, compromising the client’s respiratory status.
Why the other options are incorrect:
- A. Disconnect the chest tube from the drainage system during transport: Disconnecting the chest tube from the drainage system can lead to air entering the pleural space, which can cause a pneumothorax or worsen the client’s condition. The closed drainage system must remain intact to maintain the sterile environment and negative pressure.
- B. Empty the collection chamber prior to transport: There is no need to empty the collection chamber unless it is full or nearing its capacity. Emptying it without proper technique can introduce contamination, disrupt accurate measurement of drainage, and cause complications.
- C. Clamp the chest tube prior to transferring the client to a wheelchair: Clamping the chest tube is generally contraindicated because it can create a buildup of pressure, leading to tension pneumothorax. The chest tube should remain open to allow continuous drainage unless specifically directed by a physician under certain conditions, such as during tube changes or accidental disconnection.
In summary, maintaining the drainage system below the level of the client’s chest ensures continuous drainage of air or fluid from the pleural space and prevents potential complications such as tension pneumothorax, making option D the safest and correct action during transport.