What does it mean when there is excessive bubbling in the water seal chamber quizlet?

Monitor and maintain the patency and integrity of the drainage system.

Assess the client's vital signs, oxygen saturation, cardiovascular status, and respiratory status. Check the breath sounds bilaterally and check for symmetry of breath sounds.

Observe the dressing site at least every 4 hours. Inspect the dress- ing for excessive and abnormal drainage, such as bleeding or foul- smelling discharge. Palpate around the dressing site, and listen for a crackling sound indicative of subcutaneous emphysema.

Subcutaneous emphysema, which is air in the subcutaneous tissues,
can result from a poor seal at the chest tube insertion site.

• Determine level of discomfort with and without activity and med- icate the client for pain if indicated.

• Encourage deep-breathing exercises and coughing every 2 hours (this may be contraindicated in clients who have had a lung re- moved). Have the client sit upright to perform the exercises, and splint the chest around the tube insertion site with a pillow or with a hand to minimize discomfort.

• Reposition the client every 2 hours. When the client is lying on the affected side, place rolled towels beside the tubing. Frequent position changes promote drainage, prevent complications, and pro- vide comfort. Rolled towels prevent occlusion of the chest tube by the client's weight.

• Assist the client with range-of-motion exercises of the affected shoulder three times per day to maintain joint mobility.

• Ensure that the connections are securely taped and that the chest tube is secured to the client's chest wall.

• Keep the collection device below the client's chest level.• Frequently check the water-seal and suction control chambers. The water can evaporate and water may need to be added to the chamber. The water-seal level should fluctuate with respiratory
effort.• Assess the drainage in the tubing and collection chamber. The
drainage is measured at regularly scheduled times (check agency policy). Mark the date and time at the fluid level on the drainage chamber. The unit is not replaced until almost full.

• Avoid aggressive chest tube manipulation (e.g., milking or strip- ping the tube). Milking can create excessive negative pressure that can harm the pleural membranes and/or surrounding tissues and cause the client pain

Avoid clamping the chest tube because this increases the risk of a tension pneumothorax. You can clamp the tube for a moment to replace the drainage unit or to locate the source of an air leak, but never when transporting a client or for any extended period of time.

If the tube becomes disconnected from the collecting system, sub- merge the end in 2.5 cm (1 in.) of sterile saline or water to maintain the seal. If the chest tube is inadvertently pulled out, the wound should be immediately covered with a dry sterile dressing. If you can hear air leaking out of the site, ensure that the dressing is not oc- clusive. If the air cannot escape, this would lead to a tension pneumo- thorax. A tension pneumothorax occurs when there is buildup of air in the pleural space and it cannot escape, causing increased pressure. This pressure can eventually compromise cardiovascular function.

When transporting and ambulating the client:
a. Keep the water-seal unit below chest level and upright.
b. Disconnect the drainage system from the suction apparatus
before moving the client and make sure the air vent is open.

Use standard precautions and personal protective equipment while manipulating the system and assisting with insertion or
removal.

Keep the system closed and below chest level. Make sure all connections are taped and the chest tube is secured to the chest wall.

* Ensure that the suction control chamber is filled with sterile water to the 20-cm level or as prescribed. If using suction, make sure the suction unit's pressure level causes Slow BUT steady bubbling in the Suction control chamber.

Make sure the water-seal chamber is filled with sterile water to the level specified by the manufacturer. You should see fluctuation (tidaling) of the fluid level in the water-seal chamber; if you don't, the system may not be patent or working properly, or the patient's lung may have reexpanded.

Look for constant or intermittent bubbling in the Water-Seal Chamber, which indicates leaks in the drainage system. Identify and correct external leaks. Notify the health care provider immediately if you can't identify an external leak or correct it.

* Assess the amount, color, and consistency of drainage in the drainage tubing and in the collection chamber. Mark the drainage level on the outside of the collection chamber (with date, time, and initials) every 8 hours or more frequently if indicated. Report drainage that's excessive, cloudy, or unexpectedly bloody.

* Encourage the patient to perform deep breathing, coughing, and incentive spirometry. Assist with repositioning or ambulation as ordered. Provide adequate analgesia.

* Assess vital signs, breath sounds, SpO2, and insertion site for subcutaneous emphysema as ordered.

* When the chest tube is removed, immediately apply a sterile occlusive petroleum gauze dressing over the site to prevent air from entering the pleural space.

DON'T

* Don't let the drainage tubing kink, loop, or interfere with the patient's movement.

* Don't clamp a chest tube, except momentarily when replacing the CDU, assessing for an air leak, or assessing the patient's tolerance of chest tube removal, and during chest tube removal.

What does continuous bubbling in the water seal chamber indicate?

When excessive bubbling is observed in the water seal chamber which action would the nurse take?

What is the significance in bubbling in the water seal chamber when the chest tube is attached to wall suction quizlet?

Is constant bubbles in the water seal chamber?