Respiratory Question #26

Question

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)

Answers

  1. Presence of an occlusive dressing over the insertion area.
    • Rationale:
  2. Tidaling in the water-seal chamber with respirations.
    • Rationale:
  3. Continuous bubbling in the water-seal chamber.
    • Rationale:
  4. 100cc red blood in the drainage collection chamber.
    • Rationale:

Overview

Explanation

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.

Learning Outcomes

Test Taking Tip

Video Rationale