Question

The nurse provides care for a client after a thoracotomy. The client has a chest tube drainage system in place. Which observation most concerns the nurse?

1. The water in the suction control chamber bubbles constantly.
2. There is 700 mL of drainage in the collection chamber.
3. The level of the fluid in the water-seal chamber does not move.
4. There are air bubbles in the water-seal chamber when the client exhales.

Answer 1

The observation that most concerns the nurse is option 1: The water in the suction control chamber bubbles constantly. This indicates an air leak in the system, which can result in the collapse of one or both lungs. Options 2 and 3 are within the expected range, while option 4 is normal during exhalation.

Step-by-step explanation:

The observation that most concerns the nurse is option 1: The water in the suction control chamber bubbles constantly.

In a chest tube drainage system, the water in the suction control chamber should not bubble constantly. Constant bubbling indicates an air leak in the system, which can result in the collapse of one or both lungs. This is a serious condition that requires immediate attention.

On the other hand, options 2 and 3 are within the expected range. Option 2: There being 700 mL of drainage in the collection chamber is a normal finding as long as it does not exceed the maximal capacity of the chamber. Option 3: The level of the fluid in the water-seal chamber not moving is also normal, as long as the chamber is not overfilled or underfilled.

Option 4: Air bubbles in the water-seal chamber when the client exhales are also expected and not concerning. These bubbles indicate that air is being expelled from the lungs into the chest tube drainage system during exhalation.