Nursing Management:

1. Treatment is usually symptomatic and includes measures to promote oxygenation and comfort,
such as oxygen administration, CPT and postural drainage, antipyretics for fever management,
monitoring fluid intake, and family support.
2. To prevent dehydration, fluids are frequently administered intravenously during the acute phase.
3. Nursing care of the child with a chest tube requires close attention to respiratory status, as noted
previously.
4. Movement in bed and ambulation with a chest tube are encouraged according to the child’s
respiratory status, but children require frequent doses of analgesics such as acetaminophen and
ibuprofen or ketoralac because having a chest tube in place is quite painful.
5. If needed, supplemental oxygen may be administered by nasal cannula, face-mask, blow-by, or face
tent.
6. Children are usually more comfortable in a semierect position but should be allowed to determine
the position of comfort. Lying on the affected side (“good lung up”) splints the chest on that side and
reduces pleural rubbing that often causes discomfort.
7. Temperature is monitored regularly.
8. Vital signs and oxygenation are monitored to assess the progress of the disease and to detect early
signs of complications.
9. A nasal aspirator device can be attached to wall suction to remove secretions from nares without
causing trauma to the nasal mucosa. Older children can usually handle secretions without assistance.