A client had chest surgery this morning and has a chest tube attached to a closed-chest drainage system. When the nurse notes no tidaling of fluid, the nurse would first
a. attach the system to suction.
b. milk the chest tube.
c. notify the physician immediately.
d. reposition the client.
D
Tidaling (rise of fluid with inspiration and fall of fluid with expiration) indicates that the drainage tubes are patent and the apparatus is functioning correctly. Tidaling stops when the lung has expanded or the tubes are kinked or obstructed. If tidaling does not occur, the nurse can reposition the client, check the tubing for kinks, or have the client deep breathe and cough. If these measures do not work and if there are no blood clots or tissue fragments visible, then notify the surgeon. If blood clots or tissue fragments are visible in the tubing, milking may help reestablish the flow from the chest to the collection bottle.
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