6.1 Introduction

Learning Objectives

  • Describe the physiology of breathing and the importance of negative pressure
  • Identify indications for chest tube placement
  • Differentiate the basic compartments of a chest tube drainage system
  • Describe the safety principles essential for chest tube maintenance
  • Prioritize methods for troubleshooting chest tube drainage systems
  • Outline nursing assessments related to caring for a client with a chest tube
  • Prioritize the nursing interventions when caring for a client with a chest tube
  • Use clinical judgment to prevent, assess, manage, and document complications related to chest tubes

A chest tube is a catheter inserted into the pleural space in the chest cavity (also referred to as the thoracic cavity or thorax) to remove air, blood, and/or fluids. Chest tubes are inserted for a variety of reasons, ranging from emergent placement to routine use after cardiopulmonary surgery. Chest tubes are also often used to re-expand collapsed lungs by returning a negative pressure state within the chest cavity. The physiology of negative pressure is discussed in the “Basic Concepts” section of this chapter.

Safe management of patients with chest tube drainage systems requires an active role by the nurse. Nurses must comprehend the principles of intrathoracic negative pressure, understand the reason a chest tube is indicated for a specific patient, and be knowledgeable of potential problems and/or complications that may occur. This chapter will review the principles of intrathoracic pressure, the indications for chest tubes, and the safe management of patients with chest tube drainage systems.



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