Today our topic of discussion is Common Problems and Suggested Actions.
Common Problems and Suggested Actions
Common Problems and Suggested Actions
Lack of drainage
- Kinking, looping or pressure on the tubing may cause reflux of fluid into the intrapleural space or may impede drainage, causing blocking of the
- Nursing action: Check the system and straighten intrapleural drain tubing as required. Secure the tubing to prevent a recurrence of the problem
No fluctuation of fluid in tubing from the underwater seal
- Re-expansion of the lung Tubing is obstructed by blood clots fibrin
- Failure of the suction apparatus:Nursing action: Ask medical staff if the drain may be removed following chest X-ray. The purpose of the drain has been fulfilled. Keeping the drain in any longer than necessary may lead to hazards from infection or air re-entry. “Milk” the tubing towards the drainage bottle to try to dislodge the obstruction and re-establish potency. Straighten tubing as required.
- Secure the tubing to prevent a recurrence.
- Disconnect the suction apparatus and ensure drain is patent
Constant bubbling of fluid in the drainage
- An air leak in the system Nursing action: Clamp the intrapleural drain momentarily close to the chest wall and establish whether there is a leak in the rest of the system.
- Clamping the tubing shows whether the leak is below the level of the clamp.
- Patient shows signs of rapid shallow breathing, cyanosis,pressure in the chest, subcutaneous emphysema or hemorrhage
- Causes: Tension pneumothorax, mediastinal shift, postoperative hemorrhage, severe incision pain, pulmonary embolus or cardiac temponade
- Nursing actions: Observe record and report, any of these signs to a doctor immediately.
Incision pain
- Nursing actions: Provide analgesia as prescribed to reduce the patient’s discomfort and to enable deep breathing exercises to be performed and mobilization to ensure adequate drainage and to avoid complications
- Accidental disconnection of the drainage tubing from the intrapleural drain:
- Nursing action: Apply an artery clamp to the drain immediately in order to avoid air entering the pleural space.
- Re-establish the connection as soon as possible in order to re-establish drain age. If necessary use cleans sterile drainage tube tubing may have been contaminated when it became disconnected..
- Patient needs to be moved to another area: Nursing action: Place the drainage bottle below the level of the intrapleural drain as close to the floor as possible in order to prevent reflux of fluid into the pleural space.
- Do not clamp the drain unless the doctor has ordered it.
Intrapleural brain falls out
- Nursing action: Pull the purse string suture immediately to close the wound.
- Cover the wound with an occlusive sterile dressing. Inform a doctor.
- The objective is to minimize the amount of air entering the pleural space.
- The drain will probably need reinserting.
- Reassure the patient with appropriate explanations.
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