A nurse is assessing a client who is 1 day postoperative following a lobectomy and has a chest tube drainage system in place. Which of the following findings by the nurse indicates a need for intervention?
A.
Development of subcutaneous emphysema
B.
Chest tube eyelets not visible
C.
Continuous bubbling in the suction control chamber
D.
Presence of tidal fluctuation in the water seal chamber
The correct answer and Explanation is :
The correct answer is A. Development of subcutaneous emphysema.
Explanation:
After a lobectomy, it’s crucial to monitor for complications that could indicate issues with the chest tube or the surgical site. Subcutaneous emphysema occurs when air leaks into the subcutaneous tissue, often due to a breach in the pleura or lung tissue, which can happen post-surgery or due to improper chest tube placement. The presence of subcutaneous emphysema suggests that air is accumulating in a place it shouldn’t, which could lead to further respiratory distress or complications such as pneumothorax. Therefore, this finding requires immediate intervention.
B. Chest tube eyelets not visible may indicate that the chest tube is not properly positioned or is occluded. However, this alone does not require immediate intervention unless accompanied by other signs of distress.
C. Continuous bubbling in the suction control chamber is expected if the chest tube is set to suction. It indicates that the system is functioning correctly by allowing air to escape and maintaining the desired pressure. However, if there’s excessive bubbling, it could signal a leak or malfunction, which should be assessed further.
D. Presence of tidal fluctuation in the water seal chamber is a normal finding after surgery. Tidal fluctuation indicates that the pleural space is communicating with the chest tube and that the lung is re-expanding, which is a positive sign postoperatively.
In summary, while findings such as continuous bubbling and tidal fluctuation can be normal, the development of subcutaneous emphysema is a clear indicator of a potential complication that necessitates immediate assessment and intervention by the healthcare team.