Which practice is NOT appropriate immediately after chest-tube removal?

• A. Apply sterile dressing.
• B. Monitor for recurrence of air or fluid.
• C. Obtain a post-removal chest X-ray.
• D. Leave the dressing open and avoid imaging.

Answer: (D)

After chest-tube removal, the priority is to prevent air from re-entering the pleural space and to detect any early recurrence. Apply a sterile, occlusive dressing over the removal site to protect the wound and seal the area. Closely monitor the patient for signs of pneumothorax or fluid re-accumulation—watch for increasing shortness of breath, chest pain, rapid heart rate, low oxygen levels, or altered breathing. Obtain a post-removal chest X-ray to confirm that the lung has expanded and to rule out any residual or new pneumothorax or fluid collection. Providing oxygen as needed supports breathing while monitoring continues. Leaving the dressing open and avoiding imaging would risk air entry, infection, and missing a developing pneumothorax, which is why that approach is not appropriate.