Caring for a Jackson-Pratt or Hemovac Drain, and Penrose Drain

The nurse need to place a dressing under and around a Penrose drain. Which dressing would be best for the nurse to obtain?

A precut 4 × 4 sterile drain sponge

When removing the old dressing from the site of a Penrose drain, the nurse notes that some of the dressing material has stuck to the client's skin. What action should the nurse take next?

Apply sterile saline to loosen the dressing material from the skin.

The nurse is caring for a client with a Jackson-Pratt drain. Which intervention by the nurse is priority before beginning the dressing change?

Assessing the need for a analgesia

How often will the nurse empty a Jackson-Pratt drain? Select all that apply. At least every 4 hours When the drain is one-half to two-thirds full Once every 24 hours At least every shift Only when the drain is full

At least every 4 hours when the drain is one-half to two-thirds full

The nurse is caring for a client who has a Penrose drain. On assessment, the nurse notes that there is a safety pin on the drain just outside the wound incision area. What action should the nurse take related to this finding?

Document the presence and location of the safety pin.

How would the nurse secure a Jackson-Pratt drain after emptying it?

With a safety pin, secure the drain to the client's gown below the wound.

After emptying the drainage from a Jackson-Pratt drain, how will the nurse re-establish suction to the drain?

fully compress the bulb and reapply the cap

What is the best way for the nurse to clean the wound site in a client with a Penrose drain?

in a circular motion beginning at the pin site and moving outward toward the edge of the wound Rationale: The best way is to clean the site using a circular motion beginning at the pin site and moving outwards. The nurse should begin at the drain insertion site and slowly move in a circular motion toward the outside or periphery of the drain site. This helps to ensure that cleaning is done from the cleanest area of the wound site or drain site to least clean areas and does not contaminate the wound. Using a wedge pattern or an up-and-down pattern is more likely to cause contamination of the wound as the nurse cleans from the cleanest area, out to the least clean and then returns to most clean areas to repeat the procedure possibly bringing bacteria or other contaminants to the wound area. Using a circular motion beginning at the outer edge of the wound would be cleaning from the most contaminated area into the least contaminated area putting the client at increased risk of infection.

The nurse is caring for a Jackson-Pratt drain. Place in order, from first to last, the actions the nurse will perform. Use all options Replace the cap on the bulb. Empty the bulb's contents into the collection chamber. Wipe the outlet of the bulb with a sterile gauze pad. Place the graduated collection container under the drain outlet. Remove the cap from the bulb. Fully compress the bulb.

1)Place the graduated collection container under the drain outlet. 2)Remove the cap from the bulb. 3)Empty the bulb's contents into the collection chamber. 4)Wipe the outlet of the bulb with a sterile gauze pad. 5)Fully compress the bulb. 6)Replace the cap on the bulb.

A nurse is assisting a surgeon who will be placing a hollow, open-ended rubber tube in a client with an abscess to drain the wound. This drain will be placed such that one end will be in the abscess and the other will pass through an opening in the skin known as a stab wound. The nurse recognizes that which type of drain is needed?

Penrose drain Rationale: A Penrose drain is a hollow, open-ended rubber tube. It allows fluid to drain via capillary action into absorbent dressings. Penrose drains are commonly used after a surgical procedure or for drainage of an abscess. After a surgical procedure, the surgeon places one end of the drain in or near the area to be drained. The other end passes through the skin, directly through the incision or through a separate opening referred to as a stab wound. A biliary drain, or T-tube, is sometimes placed in the common bile duct after removal of the gallbladder (cholecystectomy) or a portion of the bile duct (choledochostomy). The tube drains bile while the surgical site is healing. A Jackson-Pratt (J-P) or grenade drain collects wound drainage in a bulblike device that is compressed to create gentle suction. It consists of perforated tubing connected to a portable vacuum unit. A Hemovac drain is placed into a vascular cavity where blood drainage is expected after surgery, such as with abdominal and orthopedic surgery. The drain consists of perforated tubing connected to a portable vacuum unit.

What is the best way for the nurse to ensure there is not any tension on the tubing when caring for a client with a Jackson-Pratt drain?

Secure the drain to the client's gown with a safety pin below the level of the wound.

The nurse is caring for a client's wound that has a Jackson-Pratt drain in place. What would be the nurse's next step after emptying the chamber's contents into the graduated collection container?

Use a gauze pad to clean the outlet