Page 89 - Critical Care Nursing Demystified

74 CRITICAL CARE NURSING DeMYSTIFIED

H ? How to Do It—Assisting With a

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Thoracentesis
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1. Observe for a health care provider’s order and signed consent form.
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2. Make sure that time is taken to verify the identity of the patient and the pro-
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cedure to be performed (time out)..
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3. Premedicate the patient.
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4. Teach the patient what will happen during the procedure.
5. Order supplies, which generally include a sterile tray with scalpel, tubing with
three-way stopcock, and specimen tubes. Bring into the site analgesic and
bottles into which the lung exudate will flow.
6. Prepare an over-the-bed table with a pillow for patient comfort.
7. Perform baseline vital signs and SaO ; auscultate lung fields.
2
8. Monitor the sterile field during the procedure and support the patient.
9. Keep the specimen tubes in a secure area to be sent to the laboratory in a Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
biohazard bag when the procedure is completed.
10. Keeping the physicians’ field sterile, attach the tubing from the needle and
three-way stopcock to the large drainage bottles if large quantities of exudate
are to be removed.
11. Assist the physician with occlusive covering of the site with a sterile dressing
after the procedure is completed.
12. Monitor vital signs, SaO , lung sounds, and insertion site for bleeding post pro-
2
cedure, according to hospital protocol. Palpate the site for crepitus.
13. Document the color, amount, and consistency of exudate removed and patient
tolerance to the procedure.
14. Clear the area, send specimens to the laboratory, and remove drainage tubes
to biohazard areas.