Nurse Lei, caring for a client with a pneumothorax and who has had a chest tube inserted, continues gentle bubbling in the suction control chamber. What action is appropriate?
A. Do nothing, because this is an expected finding.
B. Immediately clamp the chest tube and notify the physician.
C. Check for an air leak because the bubbling should be intermittent.
D. Increase the suction pressure so that the bubbling becomes vigorous.
Correct Answer: A. Do nothing, because this is an expected finding.
Continuous gentle bubbling should be noted in the suction control chamber. Bubbling during expiration reflects venting of pneumothorax (desired action). Bubbling usually decreases as the lung expands or may occur only during expiration or coughing as the pleural space diminishes.
Option B: Chest tubes should only be clamped to check for an air leak or when changing drainage devices (according to agency policy). Clamp tubing in stepwise fashion downward toward the drainage unit if air leak continues. Isolates location of a system-centered air leak.Note: Information indicates that clamping for a suspected leak may be the only time that the chest tube should be clamped.
Option C: Bubbling should be continuous and not intermittent. Seal drainage tubing connection sites securely with lengthwise tape or bands according to established policy.Prevents and corrects air leaks at connector sites.
Option D: Bubbling should be gentle. Increasing the suction pressure only increases the rate of evaporation of water in the drainage system. Position drainage system tubing for an optimal function like shorten tubing or coil extra tubing on the bed, making sure tubing is not kinked or hanging below the entrance to the drainage container. Drain accumulated fluid as necessary.
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