George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage?
A. “If there is any drainage, notify the surgeon immediately.”
B. “The drainage will decrease daily until the bile duct heals.”
C. “First, the drainage is dark green; then it becomes dark yellow.”
D. “If the drainage stops, milk the tube toward the puncture wound.”
Correct Answer: B. “The drainage will decrease daily until the bile duct heals.”
As healing occurs from the bile duct, bile drains from the tube; the amount of bile should decrease. Teach the patient to expect dark green drainage and to notify the doctor if drainage stops. Monitor intake and output (I&O) carefully, measure liquid stool. Weigh regularly. This provides direct indicators of fluid balance. Greatest fluid losses occur with an ileostomy, but they generally do not exceed 500–800 mL/day.
Option A: Monitor vital signs, noting postural hypotension, tachycardia. Evaluate skin turgor, capillary refill, and mucous membranes. Reflects hydration status and/or the possible need for increased fluid replacement.
Option C: Recommend foods used to manage constipation (bran, celery, raw fruits), and discuss the importance of increased fluid intake. Proper management can prevent or minimize problems of constipation.
Option D: Irrigations may be done on a daily basis if appropriate, although there are differing views on this practice. Many believe cleaning the bowel on a regular basis is helpful. Others believe that this interferes with normal functioning.
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