Chest Tube Case Study

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Albert has a Chest tube (CT) because there was air in his pleural space, which is called a pneumothorax. Albert likely presented with a traumatic pneumothorax on the left side with complaints of dyspnea, chest pain, and decreased breath sounds on the left side. His chest tube is located on the left side and was inserted based on CT scans and X-Rays that indicated a small left sided pneumothorax. Immediately upon insertion Albert’s respiratory status improved and there was scant blood draining in the tube. The collection chamber is hooked up to dry suction. Dry suction chest tubes should not be bubbling; bubbling in the water seal chamber indicates an air leak (Morton & Fontaine, 2012). However, if this bubbling is intermittent…show more content…
Chest-tube insertion can cause complications, such as bleeding, pain, damage to internal organs, so it is important for the nurse to anticipate complications and assess the patient’s tolerance and response to insertion. It is also important to make sure that the chest tube is not clamped, unless physician ordered, that tubing is not kinked and able to drain appropriately. Anticipate patients with CT to receive frequent X-rays and to check placement of the tube after transporting or moving to make sure the tube did not migrate from insertion. Patients with chest tubes require extra nursing assessments, care, and monitoring. At least every 2 hours, nurses should document a comprehensive pulmonary assessment, including respiratory rate, work of breathing, breath sounds, and pulse oximetery (Bauman & Handley, 2011). Nurses should inspect the dressing making sure it is occlusive and note any drainage. Tubing connection should be secured with tape. Palpation and assessment at the insertion site is important to check for subcutaneous crepitus or, air under the skin, and tube displacement, nurses can help promote drainage by keeping the Chest drainage unit below the level of the patient’s chest (Morton & Fontaine,
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