The nurse is assisting the health care provider to insert a chest drainage system for a client with a pneumothorax. Which of the following should the nurse anticipate immediately after chest tube insertion and connection to the drainage system?
1. Bubbling in the water seal chamber immediately after insertion
2. No evidence of tidaling
3. Vigorous bubbling in the suction control chamber
4. Large amount of bloody drainage in the drainage collection chamber
Bubbling in the water seal chamber immediately after insertion
Rationale: When a chest tube is inserted in the pleural space for a pneumothorax, the trapped air is allowed to escape and bubbling will be observed in the water seal as the lung is permitted re-expand. The water column in the water seal should rise with inspiration and fall with expiration (tidaling). There should be gentle bubbling in the suction control chamber to avoid rapid evaporation of the fluid in the chamber. Large amounts of bloody drainage would be anticipated after chest tube insertion for hemothorax.
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