Final answer:
Postoperative care of chest tubes after a lobectomy involves measuring drainage, assessing the dressing for bleeding, maintaining wall suction at a low setting, securing all connections, and safely repositioning the client to facilitate lung function and optimal drainage.
Step-by-step explanation:
When caring for a client who has undergone a left lung lobectomy, it is important for the nurse to adhere to specific postoperative chest tube care measures to ensure proper recovery and avoid complications. Primarily, these measures include:
- Measuring drainage at the end of each shift to monitor for any excessive fluid accumulation, which can indicate bleeding or other complications.
- Assessing chest tube dressing for signs of bleeding, infection, or other abnormalities.
- Maintaining wall suction at a low setting with intermittent bubbling, which helps to reestablish negative pressure within the chest cavity and promotes lung expansion.
- Securing all connections with tape to prevent air leaks, which can disrupt the chest tube system and compromise lung re-expansion.
It is important to note that the optimal position for drainage and lung expansion is not prone or supine but rather a semi-upright position, such as Fowler's or semi-Fowler's, which facilitates gravity-assisted drainage and optimizes lung function.
Consideration of anatomical shunts and the effects of gravity on the lungs informs postoperative positioning. The nurse must frequently reposition the client to ensure adequate ventilation and perfusion across different parts of the lung, avoiding positions that can impair gas exchange.
Knowledge of negative pressure and the role it plays in lung adherence to the chest wall is essential for understanding why maintaining airtight chest tube systems is critical. Air entering the chest cavity can disrupt this delicate balance and may lead to lung collapse, a condition known as pneumothorax.