During assessment of a patient, the chest tube becomes dislodged. What should the nurse do first?
a. Have an assistant apply an occlusive gauze dressing and tape on all four sides.
b. Clamp the chest tube.
c. Attempt to gently reinsert the tube.
d. Apply pressure over the insertion site.
D
If the chest tube becomes dislodged, immediately apply pressure over the chest tube insertion site. The nurse should first stabilize the patient to the best of his or her ability before calling the physician. Applying gauze to all four sides of an occlusive dressing would not allow for the escape of any air from the pleural space and could lead to a tension pneumothorax. Because the chest tube has become dislodged, it is outside of the body. Clamping the tube at this point would be useless. Nurses are not allowed to reinsert chest tubes. Immediately apply pressure over chest tube insertion site. Have an assistant apply gauze dressing and tape three sides. Notify the health care provider.
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