Practice Quiz

CMSRN Medical-Surgical Nursing

Category - Pulmonary

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To safely transport a client who has chest tube drainage to the X-ray department to assess the degree of lung re-expansion, the nurse would:
  1. Remove the chest tubes, immediately covering the incision site with sterile petrolatum gauze to prevent air from entering the chest
  2. Disconnect the drainage bottles from the chest tubes, covering the catheter tip with a sterile dressing to prevent contamination
  3. Send the client to X-ray with the chest tube clamped, but still attached to the drainage system to prevent air from entering the chest wall if the bottles are accidentally broken
  4. Send the client to X-ray with the chest tube attached to the drainage system, taking precautions to prevent interruption in the system
Explanation
Answer - D - Normal functioning of the chest tubes is maintained and the drainage system is transported below the level of the chest. Chest tubes are not removed (Choice A) to facilitate transportation of the client; they are removed only after the physician is satisfied with the degree of re-expansion. Removing the chest tubes from the suction drainage system (Choice B) will result in equalization of intrapleural pressures with atmospheric pressures, thus increasing the risk of pneumothorax. Current practice precludes the clamping of the chest tubes (Choice C). It is believed that clamping increases the risk of tension pneumothorax because air may enter the interpleural space during inspiration, but cannot escape during expiration.
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