Saunders Respiratory Practice

The first action a nurse should take when there has been no drainage in a closed chest tube system for one hour after a lobectomy is to check for kinks in the chest drainage system. This is essential because any obstruction, such as a kink or a blockage in the tubing, can prevent proper drainage and compromise the function of the chest tube. By identifying and correcting any kinks, the nurse can ensure that the system operates as intended, allowing for the removal of air or fluid from the pleural space, which is critical for the patient's recovery post-surgery.

While notifying the physician, measuring the output, and assessing vital signs are important steps, they may be premature without first ruling out mechanical issues such as kinks in the system. Addressing potential blockages is a straightforward, initial approach that can quickly resolve the issue and provide the necessary information about the patient's drainage needs and status.