Assessment for tracheal deviation alerts you to the possible complication of mediastinal shift. The trachea is normally positioned straight above the sternal notch. If the trachea deviates from the midline position, the surgeon should be notifi ed immediately. Secretions are monitored and reported to the physician if they become thick, yellow or green, or foul smelling. Arterial blood gases are monitored closely. Chest tubes are usually present (except following pneumonectomy) and are monitored as explained in Chapter 29. Pain is assessed using a pain rating scale, and incision sites are monitored for redness, edema, or drainage. If the patient is mechanically ventilated, additional assessment of the endotracheal tube and ventilator settings will be needed.