A patient has just had a chest tube inserted to dry-seal suction drainage.Which of the following is a correct nursing intervention for maintenance?

A) Keep the head of the bed flat for 6 hours.
B) Avoid using mouth rinses or mouthwashes.
C) Provide the patient with a paper and pencil or letter board.
D) Drain condensation into the humidifier when it collects in the tubing.

The patient being mechanically ventilated is unable to speak.This can produce extreme anxiety.An alternative method of communication must be used so the patient can express her needs and concerns.Maintain patient in semirecumbent position (head of bed elevated 30 to 45 degrees).This is extremely important to promote lung expansion,reduce gastric reflux,and prevent ventilator-associated pneumonia (VAP).Patients being mechanically ventilated are at high risk for developing VAP,which is associated with high mortality rates.Mouth rinses and mouthwashes are a part of the recommended routine for preventing VAP.They also provide comfort and preserve integrity of the mucous membranes.You should check the ventilator tubing frequently for condensation.Drain the fluid into a collection device or waste receptacle because condensation in the ventilator tubing can cause resistance to airflow.Moreover,the patient can aspirate it if it backflows down into the endotracheal tube.The fluid should not be drained into the humidifier because the patient's secretions may have contaminated it.