A patient who had a radical neck dissection has a Jackson-Pratt drain in place. The nurse observes the output from the drain over a 24-hour period. Which of the following findings should be reported to the physician immediately?

Question

A) 80 cc of serosanguinous drainage
B) 400 cc of milky or cloudy drainage
C) Spots of drainage on the dressings surrounding the drain
D) Several small clots noted in the drainage

Answer 1

Ans: B
Feedback: The presence of more that 120 cc of drainage may indicate the development of a chyle fistula as a result of damage to the thoracic duct during surgery. The drainage from a chyle fistula is generally milk-like. Laboratory analysis indicates the presence of fat. The typical amount of drainage per day during the immediate postoperative period is 80 to 120 cc. The nurse should immediately report drainage of any amount which appears cloudy. Small spots of drainage on the dressing are an expected finding; however, the nurse should circle these with a pen and monitor them closely to determine if they are increasing in circumference. This would indicate that drainage is escaping around the drain rather than through it. Small clots are also an expected finding; any frank bleeding should be reported at once.