The nurse assesses the client's water-seal drainage (WSD) system connected to two chest tubes. Which is an unexpected finding for a properly functioning WSD system?
1. Fluid drains into the WSD collection chamber slowly.
2. Serosanguinous chest tube drainage postoperatively.
3. Fluid in water-seal chamber fluctuates with breathing.
4. Tape covers WSD system vent and not the connections.
4
4. The nurse should use tape to secure every connection in the WSD system to pre-vent air leaks but not to cover the vent because the vent allows expired air to escape into the atmosphere. The water-seal in the drainage system prevents expired air from returning to the lungs.
1 and 2. The nurse expects chest tube drainage to be bloody because the client is postoperative after a thoracotomy; however, the nurse expects the drainage to dissi-pate after the first few hours of thoracic surgery and to accumulate gradually in the collection device as hemostasis and healing stop the blood flow.
3. The nurse expects to visualize fluctuations in the water-seal chamber, indicating the system is closed.
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