Final answer:
A loose-fitting dressing on the chest tube after a thoracotomy indicates immediate need for follow-up nursing actions to prevent complications such as a possible pneumothorax due to air entering the chest cavity.
Step-by-step explanation:
The patient with an air leak into the closed chest drainage system (CDS) one week post thoracotomy requires immediate follow-up nursing actions if there is a chest tube with a loose-fitting dressing. This is because a loose dressing may allow additional air to enter the chest cavity, potentially leading to a pneumothorax, where air collects in the chest cavity and can cause the lung to collapse, disrupting the negative pressure needed for lung inflation. Other options, such as having 5 cm of water in the water-seal chamber and no new drainage in the collection chamber, are typical findings and do not typically warrant immediate concern.
A small pneumothorax at the chest tube insertion site may or may not be critical depending on the size and symptoms; however, the presence of an air leak with a loose-fitting dressing is a definite sign that the integrity of the chest drainage system may be compromised, requiring immediate attention to prevent respiratory complications.