A patient with a pneumothorax has a chest tube inserted and is placed on low constant suction. Which finding requires immediate action by the nurse?
A) The patient reports pain at the chest tube insertion site that increases with movement.
B) Fifty milliliters of blood gushes into the drainage device after the patient coughs.
C) No bubbling is present in the suction control chamber of the drainage device.
D) Yellow purulent discharge is seen leaking out from around the dressing site.

Question

Quizplus · Accepted Answer

No bubbling in the suction control chamber indicates an obstruction of the drainage system. An obstruction causes increased pressure, which can cause a tension pneumothorax, which can be life threatening. The nurse needs to determine whether the leak is inside the thorax or in the tubing and act from there. Occasional blood gushes from the lung owing to lung expansion, as during a cough; this is reserve drainage. Drainage over 100 mL/hr after 3 hours of chest tube placement is cause for concern. Yellow purulent drainage indicates an infection that should be reported to the health care provider but is not as immediately life threatening as the lack of bubbling in the suction control chamber.

A Patient with a Pneumothorax Has a Chest Tube Inserted