A nurse is caring for a client who has a three-chamber closed chest tube system. Which of the following actions should the nurse take after noticing a rise in the water seal chamber with client inspiration?
A.
Immediately notify the provider.
B.
Clamp the chest tube near the water seal.
C.
Continue to monitor the client.
D.
Reposition the client toward the left side.
The Correct Answer and Explanation is:
The correct answer is C. Continue to monitor the client.
Explanation:
In a three-chamber closed chest tube system, each chamber serves a specific purpose:
- Collection Chamber: This is where the drainage from the pleural space collects.
- Water Seal Chamber: This chamber contains a column of water that acts as a one-way valve to prevent air from entering the pleural space while allowing air to escape. The rise and fall of the water level in this chamber correspond to the client’s breathing.
- Suction Control Chamber: This chamber controls the amount of suction applied to the chest tube system.
When you observe a rise in the water seal chamber during client inspiration, it is generally a normal and expected occurrence. This phenomenon is due to the negative pressure created in the pleural space as the client inhales, which draws air into the pleural cavity and causes the water in the seal chamber to rise.
Here’s why the other options are not appropriate:
- A. Immediately notify the provider: Notifying the provider immediately is not necessary unless there are other signs of complications, such as excessive drainage, abnormal bubbling, or signs of infection. A rise in the water seal chamber during inspiration alone is usually not indicative of a problem.
- B. Clamp the chest tube near the water seal: Clamping the chest tube can be dangerous as it can lead to the accumulation of air or fluid in the pleural space, potentially causing a tension pneumothorax or other complications. This action is generally only done under specific circumstances and with a provider’s order.
- D. Reposition the client toward the left side: Repositioning the client might be indicated if there is a suspicion of a problem related to the chest tube or drainage, but a rise in the water seal chamber alone does not justify this action. The rise in the water seal chamber is usually just a normal part of the breathing cycle.
In summary, a rise in the water seal chamber during inspiration is a typical finding and indicates that the system is functioning correctly. The best course of action is to continue to monitor the client and assess for any additional signs of complications or changes in the clinical picture.