Chest tube Lippincott

117. A client who underwent a lobectomy and has a water-seal chest drainage system is breathing with a little more effort and at a faster rate than 1 hour ago. The client's pulse rate is also increased. The nurse should: 1. Check the tubing to ensure that the client is not lying on it or kinking it. 2. Increase the suction. 3. Lower the drainage bottles 2 to 3 feet below the level of the client's chest. 4. Ensure that the chest tube has two clamps on it to prevent air leaks.

1. Check the tubing to ensure that the client is not lying on it or kinking it.

115. A client has a chest tube attached to a water-seal drainage system and the nurse notes that the fluid in the chest tube and in the water-seal column has stopped fluctuating. The nurse should determine that: 1. The lung has fully expanded. 2. The lung has collapsed. 3. The chest tube is in the pleural space. 4. The mediastinal space has decreased.

1. The lung has fully expanded.

46. Two days after placement of a pleural chest tube, the tube is accidentally pulled out of the chest wall. The nurse should first: 1. Immerse the tube in sterile water. 2. Apply an occlusive dressing such as petroleum jelly gauze. 3. Instruct the client to cough to expand the lung. 4. Auscultate the lung to determine whether it collapsed.

2. Apply an occlusive dressing such as petroleum jelly gauze.

116. The nurse observes a constant gentle bubbling in the water-seal column of a water-seal chest drainage system. The nurse should: 1. Continue monitoring as usual; this is expected. 2. Check the connectors between the chest and drainage tubes and where the drainage tube enters the collection bottle. 3. Decrease the suction to -15 cm H2O and continue observing the system for changes in bubbling during the next several hours. 4. Drain half of the water from the water-seal chamber.

2. Check the connectors between the chest and drainage tubes and where the drainage tube enters the collection bottle.

120. The nurse is preparing to assist with the removal of a chest tube. Which of the following is appropriate at the site from which the chest tube is removed? 1. Adhesive strip (Steri-strips). 2. Petroleum gauze. 3. 4 × 4 gauze with antibiotic ointment. 4. No dressing is necessary.

2. Petroleum gauze.

119. Which of the following should be readily available at the bedside of a client with a chest tube in place? 1. A tracheostomy tray. 2. Another sterile chest tube. 3. A bottle of sterile water. 4. A spirometer.

3. A bottle of sterile water.

111. While assessing a thoracotomy incisional area from which a chest tube exits, the nurse feels a crackling sensation under the fingertips along the entire incision. Which of the following should be the nurse's first action? 1. Lower the head of the bed and call the physician. 2. Prepare an aspiration tray. 3. Mark the area with a skin pencil at the outer periphery of the crackling. 4. Turn off the suction of the chest drainage system.

3. Mark the area with a skin pencil at the outer periphery of the crackling.

56. A client's chest tube is connected to a drainage system with a water seal. The nurse notes that the fluid in the water-seal column is fluctuating with each breath that the client takes. The fluctuation means that: 1. There is an obstruction in the chest tube. 2. The client is developing subcutaneous emphysema. 3. The chest tube system is functioning properly. 4. There is a leak in the chest tube system.

3. The chest tube system is functioning properly.

118. The nurse is assessing a client who has a chest tube connected to a waterseal chest tube drainage system. According to the illustration shown, which should the nurse do? 1. Clamp the chest tube near the insertion site to prevent air from entering the pleural cavity. 2. Notify the physician of the amount of chest tube drainage. 3. Add water to maintain the water seal. 4. Lower the drainage system to maintain gravity flow.

4. Lower the drainage system to maintain gravity flow.

114. When caring for a client with a chest tube and water-seal drainage system, the nurse should: 1. Verify that the air vent on the water-seal drainage system is capped when the suction is off. 2. Strip the chest drainage tubes at least every 4 hours if excessive bleeding occurs. 3. Ensure that the chest tube is clamped when moving the client out of the bed. 4. Make sure that the drainage apparatus is always below the client's chest level.

4. Make sure that the drainage apparatus is always below the client's chest level.

175. A client's chest tube is to be removed by the physician. Which of the following items should the nurse have ready to be placed directly over the wound when the chest tube is removed? 1. Butterfly dressing. 2. Montgomery strap. 3. Fine mesh gauze dressing. 4. Petrolatum gauze dressing.

4. Petrolatum gauze dressing.