NSG210 Week 09 Lecture: Chest Tubes
Course: NSG210 Medical-Surgical Nursing, Fall 2026 Week: 09 (Oct 19-23), lecture Oct 21, Alterations in Protection Exam: Exam 3
Source: lecture deck raw/nsg210_wk09_ChestTubes.pptx (2 slides). Slide 2 is textbook Figure 19-10, a picture of two drainage units. Chest tube nursing care is covered in more detail in the lung cancer deck: nsg210-week-09-lung-cancer-lecture. Textbook: Hinkle Ch. 19, section XIX nsg210-hinkle-ch19-chest-lower-respiratory-disorders.
Slide 1: Chest Tubes
- Goal: remove air or blood from the pleural space
- Small tube (28 Fr) near the 2nd intercostal space for air
- Large tube (32 Fr or larger) for hemothorax (textbook: at the 4th-5th intercostal space, midaxillary line)
- Decompression: insert the tube and apply suction (slide says 20 mm Hg; the textbook says 20 cm H2O, which is the standard unit)
- Sequence: insert tube, connect suction, negative pressure is restored, lung re-expands
Slide 2: Drainage Systems (Figure 19-10)
| System | How suction is controlled | Parts |
|---|---|---|
| A. Wet suction (Atrium Ocean) | Height of the water column in the suction control chamber, usually 20 cm | Suction control chamber, water seal chamber, air leak zone, collection chamber |
| B. Dry suction (Atrium Oasis) | Mechanical regulator dial | Dry suction regulator, water seal chamber, air leak monitor, collection chamber, suction monitor bellows |
Likely Exam Points
- Air rises, so the tube for air goes high (2nd intercostal space); fluid and blood settle, so the tube for blood goes low and is larger
- In a wet system, suction is set by the water height, not the wall regulator
- Suction is measured in cm H2O