The nurse caring for a client with a pneumothorax and who has had a chest tube inserted notes continuous gentle bubbling in suction control chamber. What action is most appropriate for nurse?

Correct Answer: B. Do nothing since this is an expected finding.

Continuous gentle bubbling should be noted in the suction control chamber. Bubbling should be continuous in the suction control chamber and not intermittent. The water level in the suction chamber should be at the prescribed level and gentle bubbling should be observed. The level may drop due to evaporation or over-vigorous bubbling, if this occurs top fluid level up as per manufacturer’s instructions.

• Option A: Increasing the suction pressure only increases the rate of evaporation of water in the drainage system. and this is not done without any prescription of the physician. Suction is not always required and may lead to tissue trauma and prolongation of an air leak in some patients.
• Option C: Clamping should be done if there is accidental disconnection of the system. Clamp the drain tubing at the patient end. Clean ends of the drain and reconnect. Ensure all connections are cable tied. If a new drainage system is needed, cover the exposed patient end of the drain with sterile dressing while a new drain is set up. Ensure clamp is removed when the problem is resolved.
• Option D: Chest tubes should only be clamped to check for an air leak or when changing drainage devices. An air leak will be characterized by intermittent bubbling in the water seal chamber when the patient with a pneumothorax exhales or coughs. Continuous bubbling of this chamber indicates large air leak between the drain and the patient. Check drain for disconnection, dislodgement, and loose connection, and assess patient condition. Notify medical staff immediately if a problem cannot be remedied.