Chapter 18: Care of a Client with a Tube

Students learn to identify and prevent common complications including aspiration, tube occlusion, and diarrhea, as well as techniques for delivering medications through gastric and jejunal routes. The chapter addresses specialized gastrointestinal tubes such as esophageal and lavage systems, emphasizing airway protection during emergency interventions like hemorrhage control with pressure-balloon devices. Urinary drainage management is detailed through single, double, and triple-lumen catheter options, with strict protocols for sterile insertion, specimen collection, and infection prevention in both acute and long-term care settings. Renal tubes including nephrostomy and ureteral catheters require specialized output monitoring and site care to maintain patency and prevent complications. Respiratory tube care encompasses endotracheal and tracheostomy management, with evidence-based suctioning techniques, humidification strategies, stoma assessment, and ventilator-associated pneumonia prevention protocols. The final section thoroughly explores chest tube drainage systems, explaining the three-chamber mechanism for collection, water-seal maintenance, and suction control, along with troubleshooting strategies for air leaks and emergency procedures for accidental dislodgement. Throughout all tube-related care, the chapter emphasizes safety equipment availability at the bedside, accurate documentation, client and family education, and critical thinking skills for recognizing and managing acute complications in high-acuity clinical environments.