Scenarios (All Topics)
Chest Tube Management
Nursing care for patients with a closed chest drainage system to restore negative pleural pressure and lung expansion.
Assessment
- Monitor for continuous bubbling in the water seal chamber (indicates leak)
- Assess for tidaling (fluctuation with respiration)
- Check insertion site for subcutaneous emphysema
Safety Protocols
- Keep system below the level of the patient's chest
- Keep sterile water and occlusive dressing at the bedside
- Never clamp the chest tube without a provider order
Complications
- Notify provider if drainage is >100 mL/hr
- Monitor for sudden cessation of drainage
- Assess for respiratory distress
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