Question

A client who had a choledochostomy to explore the common bile duct is returned to the surgical unit with a t-tube in place. what is the priority intervention when caring for this client?

Answer 1

The nursing care for this a patient with a t-tube in place are the following:
1) infection
2) obstruction
3) dislodgement of the tube

Priority intervention for this client is to ensure that the t-tube is properly connected to its sterile container to avoid infection. Signs of infection are redness, swelling, and warmth in the insertion area. Patient will also have an elevated body temperature of 100° F and up and will have purulent drainage on the tube. 

Answer 2

The priority intervention when caring for this client would be to provide a strict skin care and dressing changes since the bile is irritating. The T-tube normally would drain about 300 to 500 mL of blood tinge bile for the first 24 hours. This excretion is irritating to the skin so it is important to check the dressing from time to time.