Nursing Skills
Chest Tube Management
Monitoring a drainage system used to remove air or fluid from the pleural space to re-expand the lung.
System Assessment
- Ensure the chest drainage system is kept below the level of the chest.
- Monitor for tidaling in the water seal chamber (indicates patent system).
- Check for continuous bubbling in the water seal chamber (indicates air leak).
- Verify all connections are taped and secure.
Nursing Interventions
- Encourage incentive spirometry and frequent position changes.
- Assess lung sounds for re-expansion.
- Never clamp chest tube unless ordered or changing the system.
- Monitor drainage amount, color, and record output every shift.
Emergency Situations
- If chest tube is dislodged: apply sterile occlusive dressing and call provider.
- If system breaks: place tube end in sterile water to maintain seal.
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