The nurse assesses a client who has a hemothorax and a chest tube inserted on the right side. What finding requires immediate attention?
a. Pain at the chest tube insertion site
b. Fluctuation in the water seal chamber with breathing
c. Puffiness of the skin around the chest tube insertion site and a crackling feeling
d. Dullness to percussion on the affected side
C
Puffiness of the skin around the chest tube and a crackling feeling indicate subcutaneous em-physema, or air leaking into the tissue around the insertion site. This must be addressed imme-diately. A hemothorax involves bleeding into the thoracic cavity and decreased lung inflation on the affected side, resulting in duller and less resonant percussion notes. Pain at the insertion site, fluctuation in the water seal, and dullness to percussion are all expected.
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