A client has accidentally disconnected a chest tube while turning over in bed. The suction tubing is on the floor. The most appropriate action by the nurse is to
a. call the physician immediately and prepare the client for reinsertion.
b. clamp the chest tube just proximal to the open end.
c. reattach the drainage tube to the suction tubing.
d. submerge the end of the drainage tube in a bottle of sterile saline.
D
When a chest tube becomes disconnected to the suction tubing, the best action is to reattach it. However, since this suction tubing was on the floor, it is contaminated and reattaching the drainage tube to the suction tubing will place the client at an even higher risk of infection than already present. The next best action is to submerge the drainage tube into a bottle of sterile water or saline kept at the bedside for just such an occasion. If there is no fluid available, leave the tubing open rather than clamp it because clamping the tubing creates a risk for tension pneumothorax. The nurse will need to replace the contaminated suction tubing with new tubing.
You might also like to view...
A client calls the clinic and asks the nurse if using Afrin nasal spray would be alright to relieve the nasal congestion he is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications?
A) Report white patches in the mouth because Afrin can cause a fungal infection. B) Do not use Afrin for longer than 3 to 5 days in a row or rebound congestion can occur. C) Taper the dose when discontinuing the medication. D) Do not operate machinery or drive while using Afrin nasal spray.
The point where the QRS complex and ST segment meet is called the ST junction or the J point
Indicate whether the statement is true or false
A nurse practices holistic patient care. Which of the following is a guiding principle of this practice?
A) Holism is focused on reductionism. B) All living organisms exist independently. C) The body is the sum of its parts. D) The body is a unified, dynamic whole.
The nurse is conducting an early pregnancy class for a group of pregnant women. Which statement indicates a need for further education about the placenta?
1. "It develops and grows larger until about 20 weeks' gestation." 2. "It floats in the amniotic sac and filters waste products from the fetus." 3. "It creates hormones and enzymes that are necessary during pregnancy." 4. "It ages and becomes less permeable during the last month of pregnancy."