chest tube care: lab

Question 1

Why are chest tubes placed?

Answer 1

• To evacuate air from the patients chest cavity or mediastinum.
• Pneumothorax caused from injury or chest/lung surgery
• To evacuate fluid from the patients chest cavity or mediastinum:
• Blood- hemothorax, pus- empyema
• Chylothorax- white, lymphatic fluid leaking from the pleural cavity
• Pleural effusion-too much fluid in pleural space caused from Heart failure, infection (pneumonia, TB), tumors
• To prevent drained air and fluid from returning to patient.
• To restore negative pressure in the pleural space to re-expand the lung.

Question 2

what is one of the most important jobs for a nurse with chest tubes

Answer 2

• Maintain a closed drainage system
• Monitor and assess the patients breathing, gas exchange, skin integrity, chest drainage output and pain
• Promote lung re-expansion
• Prevent complications and intervene appropriately
• Complications include infection, accidental tube disconnection/removal

Question 3

what kind of water do you put in the chamber

Answer 3

sterile

Question 4

is a gentle continuous bubbling normal?

Answer 4

yes

Question 5

monitor for

Answer 5

air leaks

Question 6

air leaks

Answer 6

• Instruct patient to cough and observe the water seal chamber for the presence of bubbling
• Ask the patient to place thumb in mouth and blow out while you assess the water seal chamber.
• Does the bubbling fluctuate with inspiration or expiration or both?
• Is the bubbling continuous?
• Check connections, reinforce dressing and notify MD if continuous bubbling continues
• Bubbling in the water seal chamber is normal if CT was placed to evacuate pneumothorax and will stop once
pneumo. resolved.

Question 7

Promoting Lung Re-expansion:

Answer 7

Encourage...
• Coughing & deep breathing exercises
• Incentive spirometry
• blowing bubbles/cotton balls
• Ambulation with portable suction device
• Frequent position changes