Respiratory Question #26
The nurse is assessing the chest tube drainage of a client with a hemothorax following a motor vehicle accident. Which findings will be expected in a normal functioning chest tube system? (Select all that apply)
- Presence of an occlusive dressing over the insertion area.
- Tidaling in the water-seal chamber with respirations.
- Continuous bubbling in the water-seal chamber.
- 100cc red blood in the drainage collection chamber.
A functioning chest tube system includes having an occlusive dressing over the chest tube insertion site, tidaling in the water-seal chamber with respirations, and drainage into the collection chamber. Continuous bubbling indicates a leak in the system and is not a normal finding (Selection C). Intermittent bubbling may occur with a pleural air leak and will resolve as lung re-expands, but continuous bubbling is not normal. Other findings for management include keeping system collection container below the client’s chest and to keep water-seal and suction levels managed (add water to correct level if needed), to prevent fluid-filled dependent loops, and keep tubing free of kinks and occlusions. Since blood may be creating the hemothorax, there may should be drainage of it into the collection chamber.