Lab 2- Guidelines for T-tube Care PDF

Preview

Summary

T- Tube care after gallbladder surgery...

Description

Best Practice for Patient Safety & Quality Care Care of the Patient with a T-Tube 

Keep the drainage system below the level of the gallbladder. Maintain the patient in the semi-Fowlers’ position.



Assess the amount, color, consistency, and odor of drainage initially every 2 to 4 hours and then every 8 hours after the first 24 hours. In the immediate postoperative period, expect bloody drainage, which changes to green-brown bile. Bile output is about 400+ mL/day with a gradual decrease in amount. Report bile drainage amounts in excess of 1000 mL/day to the physician.



Report sudden increases in bile output after a normally decreasing output pattern is established.



Assess for foul odor and purulent drainage, which indicate infection or extensive inflammation. Report changes in drainage to the physician.



Inspect the skin around the T-tube insertion site for signs of inflammation, including redness, swelling, and erythema, and observe for frank bile leakage. Keep the dressing dry. (Use the hospital’s procedure and provide drain care and dressing change per protocol. The site is usually cleaned and the dressing changed daily.)



Never irrigate, aspirate, or clamp a T-tube without a physician’s request.



Assess the drainage system for pulling, kinking, or tangling of tubing, especially when the patient is positioned toward the right side.



When the patient is allowed to eat, clamp the T-tube for 1 for 2 hours (per physician’s protocol) before and after meals. Assess the patient’s response to determine tolerance of food.



Teach patient to observe stools for return of brown color 7 to 10 days postoperatively.

Ignatavicius, D., & Workman, L. (2013). Medical surgical nursing: Patient-centered collaborative care (6th ed.). Philadelphia: W. B. Saunders....