Medical Surgical Hemothorax vs Pneumothorax #5

Question

The nurse goes into the room of a client with a chest tube. The nurse notices that the thoracic catheter has dislodged. Which action would the nurse take next?

Answers

  1. Cover insertion site with petroleum jelly, apply firm pressure, notify the provider.
    • Rationale:

      This answer is correct because a dislodged thoracic catheter is a medical emergency. The nurse should cover the insertion site with petroleum jelly, apply firm pressure, and notify the provider immediately. If the client goes into respiratory distress, call a code.

  2. Reconnect the thoracic catheter to the tubing or suction using clean technique.
    • Rationale:

      This answer is not correct because the catheter is dislodged, not disconnected. If the catheter becomes disconnected, the nurse may reconnect to the tubing or suction using clean technique.

  3. Obtain an order for a chest x-ray to identify malposition of the endotracheal tube.
    • Rationale:

      This answer is not correct because there is no time for an x-ray. Early detection of a developing complication is paramount in clients with chest tubes due to the potential risk of recurrence of hemothorax/pneumothorax, or presence of infection.

  4. Administer supplemental oxygen via facemask and contact the provider.
    • Rationale:

      This answer is not correct because the immediate problem is the dislodgement of the thoracic catheter. Supplemental oxygen helps to reduce the work of breathing and promotes respiratory relief, but the thoracic catheter being dislodged requires urgent attention.

Overview

A dislodged thoracic catheter is a medical emergency. The nurse should cover the insertion site with petroleum jelly, apply firm pressure, and notify the provider immediately. If the client goes into respiratory distress, call a code.

Explanation

Learning Outcomes

Chest tubes are inserted to drain fluid (pleural effusion/hemothorax) or air (pneumothorax) from the pleural space in order to allow for lung reexpansion. It is essential to to understand the mechanics of a chest tube when assessing for signs of a malfunctioning tube or client complications. A dislodged thoracic catheter is a medical emergency. The nurse should cover the insertion site with petroleum jelly, apply firm pressure, and notify the provider immediately. If the client goes into respiratory distress, call a code. If the catheter is disconnected, the nurse may try and reconnect under clean technique.

Test Taking Tip

Read the question carefully. In the question it reads that the thoracic catheter is dislodged, not disconnected. These require very different interventions.

Video Rationale