A nurse is monitoring a client who has a chest tube in place connected to wall suction due to a right-sided pneumothorax. The client complains of chest burning. Which of the following actions should the nurse take?
A.
Increase the client’s wall suction.
B.
Reposition the client.
C.
Clamp the client’s chest tube.
D.
Strip the client’s chest tube.
The Correct answer and Explanation is:
The correct answer is B. Reposition the client.
Explanation:
When a client with a chest tube complains of chest burning, it’s essential to assess and address potential causes. The discomfort might be due to a variety of factors, including improper positioning, kinking or obstruction of the tube, or even inadequate suction settings. Here’s a breakdown of why repositioning the client is the most appropriate action:
- Repositioning the Client (Option B): The most common cause of chest discomfort in a patient with a chest tube is the position of the client. Repositioning can help relieve pressure on the chest tube, ensure it is properly draining, and might improve the client’s comfort. In many cases, adjusting the client’s position can also help alleviate discomfort caused by tube or drainage issues. If the chest tube is not properly positioned or if the client is lying in a way that causes pressure or discomfort, changing their position can help resolve the issue.
- Increasing the Wall Suction (Option A): While suction settings can impact chest tube function, increasing the suction is not indicated solely based on the symptom of chest burning. Suction levels are typically adjusted based on the need for effective drainage and not for managing discomfort. Moreover, increasing suction without a clear indication could lead to potential complications.
- Clamping the Chest Tube (Option C): Clamping a chest tube is generally not recommended unless directed by a healthcare provider for specific circumstances, such as assessing the need for a new chest tube or troubleshooting a specific issue. Clamping can lead to complications, including tension pneumothorax, which is a serious condition where air builds up in the pleural space and compresses the lung. Therefore, this action should be avoided unless under specific guidance.
- Stripping the Chest Tube (Option D): Stripping, or manually squeezing and releasing the chest tube to remove clots, is generally not recommended due to the risk of creating excessive negative pressure and potential trauma to the pleural space. It is typically avoided unless instructed by protocol or a physician.
Repositioning the client is the most prudent and safe initial approach to addressing the discomfort, as it can directly affect the position of the chest tube and relieve potential sources of pain. If discomfort persists despite repositioning, further evaluation and intervention would be warranted.