Question

Please read the following case study and answer the questions. State the rationale behind your answer. . Mr. Emery was admitted to the hospital to have a lung biopsy and resection. Following surgery, he is transferred to the surgical unit with two right pleural chest tubes connected to pleur-evac systems with 20 cm of dry suction. Chest tube A is anterior and chest tube B is lower and posterior. Orders Include: Up to the chair as tolerated Cough and deep breath 10 times per hour Change dressing daily IV of Lactated ringers at 75 ml/hour Regular diet

1. The purpose of chest tube A is mainly to?

2. It is very important to encourage Mr. Emery to cough and deep breath as ordered in order to?

3. During the initial assessment, the nurse notes continual drainage in chest tube A and no bubbling in chest tube B. This suggests what?

5. During the assessment, the nurse notices a popping feeling under the skin around the chest tube. What is this and why does it occur?

6. After the 2nd postoperative day, the bubbling disappears and the physician pulls one of the chest tubes. What instruction should the nurse give to the patient prior to the removal of the tube?

7. Once the tubes are removed, a chest x-ray is usually ordered to?

Answer 1

1.Chest tube A is to remove air.

2.Cough and deep breathing exercises are encouragedto help lungs re-expand after surgery and thereby help breathing and prevent pneumonia.

3.Chest tube B is occluded.

5.Subcutaneous emphysema and it indicates that something is wrong with the chest tube that means it may be clogged, clamped, or out of place.

6.Instruct the patient exhale to and hold the breath during which the physician can remove the tube and instruct patient to breathe normally after removing the tube.

7.Chest xay is recommmended after chest tube removal to rule out pneumothorax.