Chest Tube

You are caring for a patient who has sudden onset shortness of breath and absent breath sounds on the right side. Vital signs are pulse 110, BP 109/60, Sa02 77%, Resp 38. What is your first nursing intervention for this patient?

Call a code

Tell the doctor

Apply oxygen

Needle decompression

A patient with a large pneumothorax will present with symptoms of shortness of breath and

High blood pressure

Hypoxia

Pink frothy sputum

Gurgling airway noise

You are caring for a patient with a spontaneous pneumothorax and you are preparing the patient for a chest tube. What is the first nursing action you take?

Position the patient

Explain procedure

Set up chest tube drainage system

Obtain consent

You are assessing a patient with a chest tube for a hemp-pneumothorax and you notice the drainage to be red and note the volume to be 800cc. You note the bubbling in the air leak chamber is minimal to none. You note a tidal swing that corresponds with the patients respiration. The patient has vital signs that are BP=123/72, P=77, R=18, SA02 98% and the skin is pink warm and dry. What is your priority nursing action?

Document findings and continue to monitor patient as this is a normal finding in a patient with a hemo/pneuomthorax and the patient is stable

Contact the provider and stop the suction

Call a rapid response and apply oxygen to the patient

Increase the suction and provide positive pressure ventilation.

What equipment or medication is needed when setting up a chest tube insertion?

Gloves and goggles are needed for the MD performing the procedure

You should have sterile water and alcohol at the beside for the provider to use to prep the area

You will need antibiotics to be infused prior to starting procedure

You will need Vaseline gauze for the dressing to ensure a good seal around the tube insertion site

You are caring for a patient with a chest tube and notice bubbles in the airleak chamber of the chest tube drain. You know this to be a sign of?

An air leak between the unit and the patient

The patient is holding their breath

The patient sneezes

The suction is too high

You are setting up a dry suction unit to a patient after connecting it to the patient you notice the orange bellow has not expanded when suction applied. To correct this you will

Increase the suction amount

Disconnect the unit from the patient

Tell the patient to cough

Replace the unit because it is malfunctioning

When positioning the patient in preparation for a chest tube insertion the patient should

Be prone with head turned to the affected side

Be supine with all extremities tied down so the patient doesn’t move

Have the arm on the affected side elevated out of the way of the ribs in a position of comfort

Have feet elevated and head down with arms above head

You are assisting a provider place a chest tube in a patient and you hear a rush of air coming from the tube that was just inserted, what is you next action?

Check the patient vital signs and prepare for endotracheal intubation

Hand the provider the tube from the drainage system for them to connect to the tube on their sterile field

Ignore it because this is a normal finding and continue to monitor the patient

Turn on the suction so the device will suction the air from the lungs

You are caring for a patient who has a pneumothorax secondary to trauma. Vital signs are stable and the patient is alert and oriented. You have explained the procedure to the patient, what is the next nursing action at this time

Prepare equipment

Obtain informed consent

Position patient

Set up suction

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