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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?
*
Manual resuscitation bag, extra suction tubing, and telemetry monitor
Blood pressure cuff, portable oxygen, and incentive spirometer
Two rubber-tipped clamps, petroleum gauze, sterile 4x4s, sterile water, and tape
Foley catheter kit, IV pump, and pulse oximeter probe
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?
*
Place the chest tube drainage system above the level of the chest to prevent backflow.
Clamp the chest tube before transporting to avoid air entering the pleural space.
Place the drainage system below the level of the chest to allow proper drainage.
Disconnect the chest tube from the drainage system temporarily to make transport easier.
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?
*
Notify the physician to have chest tubes reinserted STAT.
Instruct the client to take slow shallow breaths until the tube is reinserted.
Take no action and assess the client's respiratory status every 15 minutes.
Tape a petroleum jelly occlusive dressing on three sides to the insertion site.
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?
*
Increase the suction level to improve lung re-expansion
Notify the surgeon immediately
Reassess the drainage volume in 30 minutes
Lower the head of the bed to improve blood flow
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?
*
Clamp the tubing to locate the leak
Add more sterile water to the chamber
Check the entire system for an air leak
Increase the suction pressure
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?
*
Check for kinks or dependent loops in the tubing
Increase suction to restore tidaling
Encourage him to cough forcefully
Replace the entire chest drainage system
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?
*
Reinsert the chest tube immediately
Cover the site with a sterile occlusive dressing taped on three sides
Apply pressure to the site with gauze
Notify the physician before taking any 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?
*
Document the finding as expected
Notify the physician and assess the airway
Apply warm compresses to reduce swelling
Increase the suction level on the drainage system
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?
*
Potential tube blockage—milking the tubing
Water-seal chamber malfunction—replace the system
Hypovolemia—start IV fluids
Tension pneumothorax—call for emergency help
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?
*
Recheck the drainage in 30 minutes
Clamp the chest tube to reduce blood loss
Notify the surgeon immediately
Lower suction to reduce drainage speed
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?
*
Clamp the chest tube immediately
Replace the entire drainage system right away
Increase the suction to pull fluid back down
Lower the drainage system below chest level and assess the patient
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?
*
“Inhale deeply and hold your breath during removal.”
“Breathe normally and stay relaxed.”
“Exhale fully and hold your breath during removal.”
“Take rapid breaths to reduce discomfort.”
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?
*
Reinforce the dressing and continue monitoring
Remove the dressing, clean the site, and apply a new sterile occlusive dressing
Call the physician immediately
Apply pressure to the site to stop drainage