When an unlicensed assistive personnel (UAP) assists a client with a chest tube back to bed from the bedside commode, the plastic chest drainage unit accidently falls over and cracks. The UAP immediately reports this incident to the nurse. What is the nurse's immediate action?

Question

Quizplus · Accepted Answer

If the chest tube disconnects from the drainage tubing without contamination, wipe the end of the chest tube with an antiseptic and immediately reconnect it. To prevent accidental disconnection of the chest tube from the tubing, secure all connections with tape or bands, according to hospital policy and procedure. If the chest tube is disconnected with contamination and cannot be immediately reattached, or if the chest drainage unit breaks, cracks, or malfunctions, submerge the distal end of the chest tube 1-2 in (2-4 cm) below the surface of a 250 mL bottle of sterile water or saline. This creates an immediate water seal and prevents air from entering into the pleural space as the new chest drainage system is established (Option C). To be prepared for this contingency, emergency equipment should be kept at the bedside, which includes 2 chest tube clamps, a 250 mL bottle of sterile water or saline solution, and antiseptic wipes. (Option A) Unless prescribed by the HCP, chest tube clamping time should not exceed 1 minute as it raises intrapleural pressure and can lead to a tension pneumothorax. Clamping briefly is acceptable when checking for an air leak in the system or when changing the disposable collection unit. (Option B) It is not necessary to notify the HCP when replacing a chest drainage system unless the client develops respiratory distress. (Option D) Positioning the client on the left side is appropriate if a central line is inadvertently pulled out so that any air that may have been sucked in will rise to the right atrium. It is not an appropriate intervention for a chest tube disconnection or crack or malfunction in a chest drainage unit. Educational objective: If a chest tube disconnects from the chest drainage system and cannot be reattached quickly, or if a chest drainage unit cracks or malfunctions, submerge the distal end of the chest tube 1-2 in (2-4 cm) below the surface of a 250 mL bottle of sterile water or saline solution.

When an Unlicensed Assistive Personnel (UAP) Assists a Client with a Chest