Which interventions should the nurse perform when assisting the health care provider with removal of a client's chest tube? Select all that apply. A)Ensure the client is given an analgesic 30-60 minutes before tube removal B)Instruct the client to breathe in, hold it, and bear down while the tube is being removed C)Place the client in the Trendelenburg position D)Prepare a sterile airtight petroleum jelly gauze dressing E)Provide the health care provider with sterile suture removal equipment

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A chest tube is removed when drainage is minimal (<200 mL/24 hr) or absent, an air leak (if present) is resolved, and the lung has reexpanded. The general steps for chest tube removal include: Premedicate the client with analgesic (eg, IV opioid, nonsteroidal anti-inflammatory drug [ketorolac]) 30-60 minutes before the procedure to promote comfort as evidence indicates that most clients report significant pain during removal (Option A). Provide the health care provider (HCP) with sterile suture removal equipment (Option E). Instruct the client to breathe in, hold it, and bear down (Valsalva maneuver) while the tube is removed to decrease the risk for a pneumothorax. Most HCPs use this technique to increase intrathoracic pressure and prevent air from entering the pleural space (Option B). Apply a sterile airtight occlusive dressing to the chest tube site immediately; this will prevent air from entering the pleural space (Option D). Perform a chest x-ray within 2-24 hours after chest tube removal as a post-procedure pneumothorax or fluid accumulation usually develops within this time frame. (Option C) The client should be placed in semi-Fowler's position or on the unaffected side to promote comfort and facilitate access for tube removal. Educational objective: Before chest tube removal, the client is given an analgesic and then asked to perform Valsalva during the procedure. The nurse should also bring sterile suture removal equipment and a sterile airtight occlusive dressing. Post-procedure chest x-ray is necessary within 2-24 hours.

Which Interventions Should the Nurse Perform When Assisting the Health