Chest Tubes Nursing Management Practice Questions with Answers and NCLEX Review

Introduction

• Chest tubes treat fluid accumulation in lungs to alleviate breathing issues.
• They create negative pressure for lung expansion and restore normal pleural space pressure.

Important Scenarios for Chest Tubes

• Surgery, pneumothorax, hemothorax, empyema, and chylothorax.
• Inserted in the left, right, anterior, or posterior pleural spaces.

Types of Chest Tubes

• Large-bore (>20 Fr) and small-bore (<20 Fr) for long-term use.
• Jackson-Pratt (J-tube): inserted through chest wall incision.

Chest Tube Chambers

• Suction Control Chamber: Gentle, steady bubbling preferred.
  • Memory trick: Child sucking on a milkshake.
• Water Seal Chamber & Air Lead Monitor: Tidal wave effect is good (rise & fall).
  • Memory trick: Seal in the ocean, tides up and down.
• Collection Chamber: Notify HCP if bright red blood or pulse >100 ml/hr.
  • Dark bloody drainage is normal.

Types of Chest Tube Drainage Systems

• Gravity System: Fluid drainage through gravity.
• Pressure System: Pump for active fluid removal.
• Vacuum System: For severe respiratory distress, actively removes fluid.

Nursing Care for Chest Tubes

• Assessment: Lung sounds regularly.
• Monitoring: Vital signs every 15 mins, consciousness, breathing ability.
• Observation: Infection signs (redness, swelling, drainage), hemolysis signs.
• Documentation: Fluid intake and output.
• Comfort and Mobility: Positioning, pain relief, mobility exercises.

Chest Tube Removal

• Primarily surgeon's responsibility, but nurses assist.
• Emergency Preparedness: Vaseline gauze for accidental removal.
• Disconnection Solutions:
  1. Distal end in 250ml sterile saline.
  2. Water seal chest tube damage repair.

Study Tips for NCLEX

• SimpleNursing Membership: Access to videos, cheat sheets, study guides.
• Testimonial: Personal success story with nursing exams.

These notes capture the essence of chest tubes in nursing management, including care, maintenance, and removal, along with practical tips for handling emergencies. The inclusion of study aids underscores the importance of preparation for nursing exams like the NCLEX.