In: Nursing
Consider the following situations. What is the appropriate response for each and what would you do to calm the sitatuion?
1. The patient’s chest tube comes out
2. The amount of drainage from the chest tube has suddenly decreased
3. While performing the chest tube dressing change, the nurse notes a crackling sensation on palpation.
4. The nurse notices fluctuation in the connection tubing with inhalation and exhalation.
1.
Suddenly apply pressure to chest tube insertion site and sterile dressing with sterile gauze tightly to avoid air entery .Inform to consultant as early as possible for to make sure life threatening situations or not.
2.
Suddenly decreasing the drain volume is sign of blood clot or obstruction .If chest drain is not swinging ,not in connected with the pleural space either due to blockage ,kinking or withdrawal to the thoracic wall.Teach and promote deep breathing and coughing exercise .This will help the lung to expand and allow blood drainage to avoid tube block .
3.
Crackling sensation felt on palpation is air under the skin known as subcutaneous crepitation is form of crepitus.Due to poor tube placement and blocakage leads to carbon dioxide escapes in to the tissues.
4.
Fluctuation or swinging is the changes of pressure during the respiratory cycle.If a chest tube is in pleural space it will change pressure moving to and fro with respiration.