The client has chest tubes in place following thoracic surgery. ...

[LCritchfi]

The client has chest tubes in place following thoracic surgery. In working with a client who has a chest tube, the nurse should:
 
  1. Clamp the tubes except during client assessments
  2. Remove the tubing from the connection to check for adequate suction power
  3. Milk or strip the tubes every 15 to 30 minutes to maintain drainage
  4. Coil and secure excess tubing next to the client

Question 2

In teaching a client about an upcoming diagnostic test, the nurse identifies that which one of the following uses an injection of contrast material?
 
  1. Holter monitor
  2. Echocardiography
  3. Cardiac catheterization
  4. Exercise stress test

[jessofishing]

Answer to Question 1

ANS: 4
If the client is in a chair and the tubing is coiled, the tubing should be lifted every 15 minutes to promote drainage. Care should be taken to ensure the tubing remains secure. Clamping the tubes except during client assessments is an inaccurate statement. Clamping a chest tube is contraindi-cated when the client is ambulating or being transported. In a water-sealed system, gentle bub-bling in the suction-control chamber indicates it is functioning. The suction source may be checked to verify it is on the appropriate setting. In a waterless system, the suction control (float ball) indicates the amount of suction the client's intrapleural space is receiving. The tubing should not be disconnected. The chest tube should be stripped or milked only if indicated (e.g., there is clotted drainage in the tube) (check institutional policy). It is believed that stripping the tube greatly increases intrapleural pressure, which could damage the pleural tissue and cause or worsen an existing pneumothorax. Milking causes less of a pressure change.

Answer to Question 2

ANS: 3
A cardiac catheterization involves the injection of contrast material in order to visualize the car-diac chambers, valves, the great vessels, and coronary arteries. It also is used to measure the pressures and volumes within the chambers of the heart. A Holter monitor is a portable ECG worn by the client. It does not require contrast media. An echocardiography is a noninvasive measure that graphically depicts overall cardiac performance. An exercise stress test evaluates the cardiac response to the physical stress of the client on a treadmill. Contrast material is not used for this test.

[LCritchfi]

Excellent

[phuda]

TYSM