Definitions and Equipment
3 indications for a chest tube
pleural effusion, pneumothorax, hemothorax
How often should a chest tube dressing be changed?
What is.. Every three days and PRN if wet, soiled, or no longer intact.
True or False: Chest tubes can be connected to a drainage bag.
What is... false
What is an air leak indicator used for?
What is...to approximate the degree of air leak from the chest cavity.
What type of dressing is applied after chest tube removal?
What is...Sterile, occlusive, petrolatum-based dressing (e.g., Adaptic® + gauze).
Name of chest tube drainage system at TOH.
What is Pleur-Evac® Sahara® drainage system?
When transporting a patient, what is required if they are on wall suction?
What is...A physician’s order to disconnect from wall suction.
What should a nurse do if a chest tube becomes disconnected?
What is... Clamp the tube, clean with chlorhexidine, reconnect, and obtain a new drainage system ASAP.
What should be done if there is a sudden decrease in chest tube drainage?
What is... Assess for kinks, migration of the tube, or blockage and notify the physician.
How long should the occlusive dressing stay in place post-removal?
What is..48 hours
What does the Negative Pressure Indicator confirm?
What is negative pressure is maintained within the system.
What must always be available at the patient’s bedside for a chest tube?
What is.. Two toothless disposable clamps per chest tube.
Why should chest tube stripping or milking be avoided?
What is... It creates high negative pressure, which can cause pain, tissue trauma, and bleeding.
What indicates that the wall suction is working correctly?
What is...The orange float appears in the suction control indicator window.
What must a nurse document regarding chest tube removal?
What is...Patient assessment, dressing application, and patient education.
What is the difference between a large-bore and small-bore chest tube?
Large-bore: ≥20 Fr, rigid plastic; Small-bore: <20 Fr, may have a curled tip (pigtail).
What are the three key assessment findings for chest tube care?
What is.. Drainage amount & color, presence of air leak, and chest tube dressing integrity.
What are the only acceptable reasons to clamp a chest tube?
What is... Changing the system, taking a sample, troubleshooting an air leak, or with a physician’s order.
How do you determine the source of an air leak in the drainage system?
What is.. Clamp near the patient → If bubbling stops, the leak is likely at the insertion site. If it continues, check connections and the drainage system.
What patient education should be provided before discharge after chest tube removal?
What is...When to remove the dressing, when to seek medical attention, and follow-up instructions.
What is the function of the Manual High Negativity Pressure Relief Valve?
What is.. vents excessive negative pressure in the drainage system.
When should the Sahara® drainage system be changed?
What is...When it is full, knocked over, or every seven days.
If a chest tube is accidentally dislodged, what is the immediate nursing action?
What is...Cover the site with an occlusive dressing (adaptic + gauze), tape three sides, stay with the patient, and notify the physician immediately.
What should a nurse do if the negative pressure indicator does not display "YES"?
What is...Check for leaks, ensure all connections are tight, and replace the system if needed.
When should the dressing be left open to air?
What is....If there is no drainage present after 48 hours.