NCLEX-PN® ExaminationSafety and Infection ControlHard
An LPN is assisting with the care of a client who has a chest tube connected to a closed drainage system. The LPN notes continuous bubbling in the water seal chamber. What is the most appropriate initial action for the LPN to take?
- AIncrease the suction pressure to resolve the bubbling.
- BCheck all connections from the client to the drainage system.
- CClamp the chest tube close to the client's chest to locate the leak.
- DNotify the registered nurse (RN) immediately as this indicates a severe problem.
Show answer & explanationAnswer & explanation
Correct answer: B. Check all connections from the client to the drainage system.
Continuous bubbling in the water seal chamber, especially if new or excessive, often indicates an air leak in the system. The LPN's initial action should be to systematically check all connections from the insertion site to the drainage system to identify and resolve any loose connections, which is the most common cause of air leaks.
Why the other options are wrong
- A. Increasing suction pressure will not fix an air leak and could potentially worsen the issue or cause damage.
- C. Clamping the chest tube is generally avoided due to the risk of tension pneumothorax and should only be done briefly by an RN or provider for specific diagnostic purposes.
- D. While an air leak is a concern, it's often manageable by checking connections. Notifying the RN is appropriate after initial assessment and intervention, if the leak persists or is significant.
Chest Tube Air Leak Assessment
The process of identifying and troubleshooting the source of continuous air bubbling in the water seal chamber of a chest tube drainage system, indicating air is entering or escaping the pleural space or the system itself.
- Continuous bubbling signifies an air leak.
- Check connections first, starting from the client.
- Clamping is generally avoided due to risk of tension pneumothorax.
- Notify RN if leak persists or client status changes.
Memory trick: Connect Carefully, Catch the Leak