A postoperative thoracotomy client with a chest tube is on day 1. Which interventions should be included in the plan of care? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Postop thoracic surgery bundle prevents VTE and atelectasis: SCDs in bed, hourly incentive spirometry, early ambulation. Drainage MUST be kept BELOW the chest level so gravity does not return fluid to the pleural space. Bright red drainage exceeding 100 mL per hour for 2 hours, or 200 mL in the first hour, warrants immediate surgeon notification for possible hemorrhage.
Memory: chest tube system below chest, never clamp during transport (only briefly to change unit), keep upright. Tidaling = patent tube; cessation = obstruction or full re-expansion.
Pleural drainage 80 mL serosanguineous in the last 8 hours. Pain 5/10 on PCA hydromorphone. Tidaling present. SCDs at bedside.
tidaling — Fluctuation of fluid in the water-seal column with respiration; indicates patent system.
sequential compression device — Pneumatic leg sleeve preventing VTE in immobile patients.
incentive spirometry — Device promoting deep inhalation to prevent postoperative atelectasis.