Tubes, Catheters, and Chest Drainage Nursing Care for NCLEX-PN | Chapter 18 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

Tubes, Catheters, and Chest Drainage Nursing Care for NCLEX-PN | Chapter 18 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

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Welcome to Chapter 18 of the Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri. This chapter is an in-depth guide to nursing care for clients with NG tubes, urinary and renal catheters, tracheostomies, and chest drainage systems. Mastering these protocols is vital for NCLEX-PN success and for ensuring patient safety in any clinical setting.

Watch the full chapter video summary below, and subscribe to Last Minute Lecture for practical NCLEX-PN skills, troubleshooting, and nursing procedures:

Nasogastric (NG) Tubes and Enteral Feeding Management

  • Placement and Verification: Confirm tube placement by x-ray and pH check before feedings or medications.
  • Feeding Types: Bolus, continuous, and cyclic feedings—follow safe administration protocols and monitor for aspiration, clogged tubes, and GI upset.
  • Medication Administration: Crush and dilute meds as appropriate, flush before/after, and avoid mixing multiple meds at once.

Lavage and Esophageal Tubes

  • Sengstaken-Blakemore and Lavage Tubes: Used for GI bleeding; monitor for airway obstruction and provide emergency scissors at bedside.
  • Implement frequent monitoring and airway protection measures.

Urinary and Renal Catheter Care

  • Foley, Ureteral, and Nephrostomy Tubes: Sterile technique for insertion and removal, frequent perineal care, and meticulous output monitoring.
  • Watch for infection, kinks, or obstruction; never clamp nephrostomy tubes without provider order.

Respiratory Tubes: Tracheostomies and Endotracheal Tubes

  • Suctioning: Use sterile technique, limit suction time, and oxygenate before/after to prevent hypoxia.
  • Stoma Care: Keep site clean and dry, change ties and dressings per protocol, and prevent skin breakdown.
  • Ventilator-Associated Pneumonia Prevention: Elevate HOB, perform oral care, and minimize circuit breaks.
  • Extubation Emergencies: Be prepared with an Ambu bag, monitor airway, and provide rapid intervention if tube dislodgement occurs.

Chest Tube Drainage Systems

  • Types of Systems: Water-seal, suction-control, and dry suction systems; monitor all chambers for proper function and drainage amount.
  • Troubleshooting: Watch for air leaks, sudden cessation of output, or drainage >100 mL/hr. If dislodged, apply occlusive dressing and notify provider immediately.
  • Keep clamps and sterile water at bedside for emergencies; never clamp chest tube routinely.
  • Removal Protocols: Prepare client, instruct on Valsalva maneuver, and monitor for respiratory distress after removal.

Documentation, Infection Prevention, and Patient Teaching

  • Document insertion, maintenance, output, and removal for all tubes. Note complications, interventions, and client teaching provided.
  • Teach clients and families about tube care, signs of infection, and when to seek help.

Want hands-on demonstrations and troubleshooting tips? Watch the video above and subscribe to Last Minute Lecture for every NCLEX-PN chapter walkthrough and clinical skill demo!

Conclusion: Nursing Competence with Tubes and Drainage Systems

Chapter 18 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) empowers you to safely manage tubes, catheters, and chest drainage in the clinical setting. Through vigilant monitoring, infection control, and patient teaching, you’ll reduce risk and promote healing for every client—on the exam and in your nursing practice.

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