A nurse is caring for a client who has a chest tube. Which of the following actions should the nurse take?
A.
Loop the tubing of the chest tube on the client’s bed.
B.
Strip the client’s chest tube every 2 hrs.
C.
Place the chest tube drainage system below the level of the client’s heart.
D.
Tape the connections on the client’s chest tube.
The Correct Answer and Explanation is:
The correct answer is C. Place the chest tube drainage system below the level of the client’s heart.
Explanation:
When managing a chest tube, it is crucial to ensure proper drainage and prevent complications. The chest tube is used to remove air, fluid, or blood from the pleural space to allow the lungs to expand fully and function properly. Here’s a breakdown of the actions listed and why option C is the best choice:
- Loop the tubing of the chest tube on the client’s bed (Option A):
- Explanation: Looping the tubing on the bed is not recommended as it can create dependent loops. Dependent loops can lead to fluid accumulation and potential obstruction of the drainage system. The tubing should be secured properly without kinks or loops, and it should be positioned in a way that allows for continuous drainage and prevents backflow.
- Strip the client’s chest tube every 2 hrs (Option B):
- Explanation: Stripping the chest tube involves pulling the tubing to remove clots or debris, which is an invasive procedure that is generally not recommended for routine care. Frequent stripping can increase the risk of damage to the tube and trauma to the pleura. Instead, gentle milking (if necessary) or ensuring that the tubing remains patent and unobstructed is preferred. The frequency of such procedures should be determined by clinical guidelines and the specific needs of the patient.
- Place the chest tube drainage system below the level of the client’s heart (Option C):
- Explanation: This is the correct action. The chest tube drainage system should always be placed below the level of the client’s heart. This positioning utilizes gravity to facilitate proper drainage of fluid or air from the pleural space. It helps ensure that any fluid or air that accumulates drains out effectively, preventing complications such as fluid accumulation or re-expansion of pneumothorax.
- Tape the connections on the client’s chest tube (Option D):
- Explanation: While it is important to ensure that connections are secure to prevent leaks, excessive taping is not recommended. The connections should be secure, but taping should be done carefully to avoid impairing the tube’s function or creating discomfort for the patient. Regular inspection of the connections and ensuring they are properly sealed is crucial.
In summary, placing the chest tube drainage system below the level of the client’s heart (Option C) is essential for optimal drainage and to avoid complications. Proper management of the chest tube involves positioning the system correctly, avoiding excessive manipulation, and securing connections without impairing tube function.