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1. Question
The nurse is monitoring the chest tube drainage system in a client with a chest tube. The nurse notes intermittent bubbling in the water seal chamber. Which is the most appropriate nursing action?
Correct
Answer: Option B is the correct Answer.
Rationale: Bubbling in the water seal chamber is caused by air passing out of the pleural space into the fluid in the chamber. Intermittent (not constant) bubbling is normal. It indicates that the system is accomplishing one of its purposes, removing air from the pleural space. Continuous bubbling during inspiration and expiration indicates that an air leak exists. If this occurs, it must be corrected. Notifying the health care provider and changing the chest tube drainage system are not indicated at this time.
Test-Taking Strategy: Note the strategic words, most appropriate. Note the subject, chest tube drainage systems, and focus on the words intermittent bubbling and water seal chamber. Recalling that intermittent (not constant) bubbling is normal in this chamber will direct you to the correct option.
Incorrect
Answer: Option B is the correct Answer.
Rationale: Bubbling in the water seal chamber is caused by air passing out of the pleural space into the fluid in the chamber. Intermittent (not constant) bubbling is normal. It indicates that the system is accomplishing one of its purposes, removing air from the pleural space. Continuous bubbling during inspiration and expiration indicates that an air leak exists. If this occurs, it must be corrected. Notifying the health care provider and changing the chest tube drainage system are not indicated at this time.
Test-Taking Strategy: Note the strategic words, most appropriate. Note the subject, chest tube drainage systems, and focus on the words intermittent bubbling and water seal chamber. Recalling that intermittent (not constant) bubbling is normal in this chamber will direct you to the correct option.
Chest Drainage System:
One-piece, disposable plastic drainage systems, such as the Pleur-evac, contain three chambers. The drainage chamber is on the right and has three calibrated columns that display the amount of drainage collected. When the first column fills, drainage carries over into the second and, when that fills, into the third. The water-seal chamber is located in the center.
The suction-control chamber on the left is filled with water to achieve various suction levels. Rubber diaphragms are provided at the rear of the device to change the water level or remove samples of drainage. A positivepressure relief valve at the top of the water-seal chamber vents excess pressure into the atmosphere, preventing pressure buildup.
