Chest Tube Thorascostomy (13 Questions)

1.1 Mme. Isabelle Lefebvre, a 70-year-old client, is three days post-lobectomy and has a chest tube in place. The chest tube is functioning properly with minimal drainage and no signs of an air leak. The physician has ordered a CT scan of the chest. As the nurse prepares to transport Mme. Lefebvre to the radiology department, safety precautions must be taken in case the chest tube becomes dislodged or disconnected during transport.

Question:
Which supplies should the nurse bring when transporting this patient for a CT scan? *
1.2 As the orderly arrives with the stretcher, the nurse double-checks the setup of the chest tube drainage system to ensure it remains safe and functional during transport.

Question:
What should the nurse ensure during the transport? *
1.3 As Mme. Isabelle Lefebvre is preparing for transport to the CT scan, she attempts to get out of bed with assistance. In the process, the chest tube is accidentally pulled out of the pleural space. She immediately gasps and clutches her side. The nurse notes that the insertion site is open and exposed. Mme. Lefebvre appears mildly short of breath but is conscious and responsive. The nurse quickly moves to respond to the emergency.

Question:
Which action should the nurse implement first? *
2. Mr. Delorme, 59, is on post-operative day 1 after a left lobectomy. He has a chest tube connected to a wet suction drainage system. Over the last hour, you note a sudden increase in bloody drainage from 40 mL/hr to 220 mL/hr. His BP drops from 122/78 to 96/60, HR is 118 bpm, and he reports feeling “very weak.” His dressing remains dry, and the tubing is intact without kinks.

Question:
What is the priority nursing action? *
3. Ms. Roy, 47, is admitted with a spontaneous pneumothorax and has a chest tube connected to a wet-seal system. During your assessment, you observe continuous bubbling in the water seal chamber. Her breath sounds are equal bilaterally, and she denies dyspnea. All tubing connections appear intact.

Question:
What should the nurse do first? *
4. Mr. Nguyen, 72, had a left thoracotomy for decortication. During your chest tube assessment, you note no tidaling in the water seal chamber. The patient is breathing comfortably, and his oxygen saturation is 95% on 2 L/min. The dressing is dry and intact.

Question:
What should the nurse assess first? *
5. Ms. Bouchard, 31, had a chest tube inserted for traumatic pneumothorax. While turning in bed, the chest tube suddenly falls out of the insertion site. You hear air escaping from the wound, and the patient becomes anxious and dyspneic.

Question:
What is the nurse’s priority action? *
6. Mr. Gervais, 66, has a chest tube for a large pneumothorax. During your assessment you notice crackling under the skin around the insertion site extending to the chest and neck. He denies pain and is breathing comfortably. The dressing is secure, and the water seal shows intermittent bubbling.

Question:
What should the nurse do first? *
7. Mr. Florent, 50, is recovering from thoracic surgery and has a chest tube in place. He suddenly becomes acutely short of breath, with tracheal deviation to the left, distended neck veins, and oxygen saturation dropping to 86% on 6 L/min. His chest tube system shows no bubbling and no drainage.

Question:
What should the nurse suspect and prioritize? *
8. Ms. Lafrance, 73, has a chest tube following thoracotomy for lung cancer. Over the past hour, the drainage is bright red and totals 160 mL. She reports dizziness. Her BP is 98/64, HR 110 bpm. Suction is functioning normally.

Question:
What is the priority nursing action? *
9. Ms. Pelletier, 45, has a chest tube after pleural effusion drainage. You notice the drainage system is accidentally lifted above the patient’s chest level while she was being repositioned. Fluid begins to backflow into the tubing.

Question:
What should the nurse do first? *
10. Mr. Lapierre, 63, is scheduled to have his chest tube removed following resolution of a pneumothorax. The physician is preparing for the procedure at the bedside. The patient is anxious and asks, “What do I need to do when they take it out?”

Question:
What instruction should the nurse give? *
11. Ms. Simard, 51, has a chest tube placed for hemothorax. During morning care, you find her dressing completely saturated with serosanguinous fluid. She reports mild pain but no respiratory difficulty. The tubing is intact and drainage is 60 mL/hr.

Question:
What is the nurse’s best action? *