If a closed chest tube becomes disconnected, what is the nurse's first action?

Submerging the end of the disconnected chest tube in a bottle of sterile water is the appropriate initial action in the event of disconnection. This method serves as an immediate safety measure to prevent air from entering the pleural space, which could lead to a tension pneumothorax or other complications. By placing the tube in sterile water, it creates a water seal that allows air to escape while preventing outside air from entering the thoracic cavity, thus maintaining the negative pressure essential for lung expansion.

In the context of emergency response, while clamping the chest tube might seem like a quick fix, it can actually increase the risk of a tension pneumothorax if there is any air leak. Replacing the chest tube is also a necessary step but is not the immediate priority after disconnection. Similarly, contacting the health care provider is important but should follow the initial action that ensures patient safety. This reflects a systematic approach to handling potential emergencies in clinical settings, prioritizing immediate interventions that stabilize the patient first.