Pharmacological and Parenteral Therapies Q 4
The nurse is caring for a 30-year-old male admitted with a stab wound. While in the emergency room, a chest tube is inserted. Which of the following explains the primary rationale for insertion of chest tubes?
A. The tube will allow for equalization of the lung expansion.
B. Chest tubes serve as a method of draining blood and serous fluid and assist in re inflating the lungs.
C. Chest tubes relieve pain associated with a collapsed lung.
D. Chest tubes assist with cardiac function by stabilizing lung expansion.
Correct Answer: B. Chest tubes serve as a method of draining blood and serous fluid and assist in re inflating the lungs.
Chest tubes work to reinflate the lung and drain serous fluid. Physicians use a chest tube to create negative pressure in the chest cavity and allow re-expansion of the lung. It helps remove air (pneumothorax), blood (hemothorax), fluid (pleural effusion or hydrothorax), chyle (chylothorax), or purulence (empyema) from the intrathoracic space.
Option A: The tube does not equalize the expansion of the lungs. There are other uses for a thoracostomy tube that are not as common and rarely indicated. Typically for a tension pneumothorax needle decompression occurs first and chest tube placement quickly follows after the patient stabilizes from decompression.
Option C: Pain is associated with the collapse of the lung, and insertion of chest tubes is painful. A chest tube, also known as a thoracostomy tube, is a flexible tube that can be inserted through the chest wall between the ribs into the pleural space.
Option D: This is not the primary rationale for performing chest tube insertion. Thoracostomy tubes are commonly made from PVC or silicone. They range from 6 French to 40 French. The majority are fenestrated along the sides of the insertion end, and the tubes have a radiopaque stripe. After placement, the distal end of the tube is connected to a pleur-evac system. There are three chambers of a pleur-evac: suction chamber, water seal chamber, and the collection chamber. The water seal chamber acts as a one-way valve allowing air to escape from gravity, but not to re-enter the thoracic cavity.