What is the nurse's first step if there is no drainage observed in a closed chest tube system after a lobectomy?

The first step in addressing the absence of drainage in a closed chest tube system after a lobectomy is to check for kinks in the drainage system. This is crucial because kinks can obstruct the flow of fluid or air, preventing proper drainage. Assessing the system for kinks helps ensure that it is functioning as intended.

If kinks are found and corrected, this may resolve the issue without needing further intervention. It also helps to prioritize less invasive measures before considering more significant steps, like changing the chest tube or notifying a physician.

Changing the chest tube immediately may not be necessary if the problem can be addressed by correcting the system's position. Notifying the physician would be appropriate if other interventions do not resolve the issue but is not the primary step to take immediately. Similarly, measuring vital signs is essential in nursing care, but it doesn't directly address the immediate problem of drainage in this context.

Therefore, checking for kinks in the drainage system is the most logical and immediate action to take in this situation.