A client is being urgently transported to radiology for a Computerized Tomography (CT scan) after a sudden decrease in the level of consciousness. The client is orally intubated and has a left lateral chest tube to 20 cm suction. Which action is most important for the nurse to take?
Explanation & Rationale
A. Secure chest tube to the stretcher for transport: While securing the chest tube is important to prevent dislodgement during transport, the priority is to ensure proper drainage and prevent air leaks by keeping the chest tube container below the site of insertion. B. Mark the amount of chest drainage on the container: While it's important to document chest drainage, ensuring proper drainage by keeping the container below the insertion site takes precedence, especially during transport. C. Keep the chest tube container below the site of insertion: Correct! Keeping the chest tube container below the site of insertion ensures continuous drainage of air and fluid from the pleural space, which is crucial for maintaining respiratory function and preventing complications such as pneumothorax. D. Administer PRN pain medication prior to transport: Pain management is important, but in this urgent situation, maintaining proper chest tube function and respiratory support is the priority.