Anjae Kristelle Gariando

BSN 3-2

Reflective Essay: Chest Tube Basics for Nurses

This essay tackles the chest tube basics for nurses. In the video, the nurse
explained that chest tube is used to relive or remove what is obstructing in the pleural
space that disrupt the normal negative pressure that’s within the chest. Chest tubes are
used to treat disorders that cause the pleural space to become obstructed.

Chest tube care might be frightening for nurses, but it doesn't have to be. Once
you've mastered the fundamentals, you'll be able to confidently care for patients with
chest tubes. Chest tubes have different sizes depending on how big the pneumothorax.
Ut has holes in it that allow air, fluid, blood, and pleural effusion to escape and go to the
chest tube drainage unit. Trocar is a sharp-pointed instrument used to puncture the wall
of body cavity. A chest tube drainage unit is a sterile, disposable device that comprises
of a compartment system with one or more chambers and a one-way valve to remove
air or fluid and prevent it from returning to the patient. There are usually three chambers
in a standard chest drainage unit namely: Collection chamber, Water-seal chamber, and
wet or dry suction control chamber. The collection chamber, which collects drainage
from the pleural cavity, is directly connected to the chest tube. The drainage is
measured in the chamber, which is calibrated. The chamber's outside surface contains
a write-on surface for recording the date, time, and amount of fluid. Water-seal
chamber, due to the pressure in the chamber, includes a one-way valve that permits air
to depart the pleural cavity during exhale but not re-enter during inhalation. To
guarantee optimal operation, the water-seal chamber must be filled with sterile water
and kept at the 2 cm mark. It should also be checked on a regular basis. If necessary,
top up with sterile water. Water should rise with inhale and drop with exhale in the
water-seal chamber, or what we call tidaling, indicating that the chest tube is patent.
Continuous bubbling could be an indication of an air leak.

In wet suction control chamber, the amount of water is normally controlled by the
level of water in the suction control chamber, which is typically set at -20 cm for adults.
There is less suction when there is less water. The quantity of suction is controlled by
the chest drainage system, not the suction source, and varies based on the patient.
Keep an eye on the fluid level to make sure to have bubbles. A self-controlled regulator
in a dry suction system controls the amount of suction and responds to air leaks to
provide consistent suction for the patient. If suction is turned off, the suction port
on the chest drainage system must stay clear and exposed to the air to allow air to
escape and prevent a tension pneumothorax from forming.

As a rule, never ever clamp the test tube. Ensure tubing is not kinked or bent under the
patient or in the bed rails, or compressed by the bed. There are also few instances
when you need to clamp and that is to know where the link and when the collection
chamber gets full and needed to be change. In resolving pneumothorax, place in 2 nd
ICS and for hemothorax, between 5th or 6th ICS.

As a future nurse, we should always keep in mind the special considerations

during the procedure. Aside from all universal nursing interventions like hand hygiene,
nurse patient-interaction and environmental awareness whenever the procedure
happens, as nurses advance in their careers, they must learn how to properly care for
chest tubes and how to change their patients' chest tube dressings. Nurses' experience
is relied upon by patients to guarantee that their medical care is as exact as possible.
After the chest tubes have been appropriately implanted, nurses are responsible for
caring for them so that the pleural drainage system remains clear and intact. When it
comes to providing care to patients, nurses have a lot of duty. In order to avoid
infections and life-threatening illnesses, the patient's chest tube must be properly cared
for. With practice, nurses will be able to easily care for chest tubes.