A patient with a chest tube has continuous bubbling in the water seal chamber. What does this indicate?
Normal fluctuation with breathing
Fluid accumulation in the pleural space
Air leak from the patient's lung
Chest tube obstruction
The Correct Answer is C
A. Normal fluctuation with breathing: Normal fluctuation, known as tidaling, involves the water level in the water seal chamber rising during inspiration and falling during expiration. Continuous bubbling, however, is not normal and indicates a different issue.
B. Fluid accumulation in the pleural space: Fluid in the pleural space would be indicated by increased drainage in the collection chamber, not by continuous bubbling in the water seal chamber. Bubbling is related to air movement, not fluid buildup.
C. Air leak from the patient’s lung: Continuous bubbling in the water seal chamber suggests that air is escaping from the pleural space into the drainage system. This indicates an air leak, which may originate from the lung itself, the chest tube insertion site, or the tubing connections.
D. Chest tube obstruction: An obstruction would cause absent or decreased drainage and loss of tidaling, not continuous bubbling. Bubbling requires airflow through the system, which would not occur if the tube were blocked.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hyperoxemia: Excess oxygen in the blood usually does not cause anxiety, confusion, or tachypnea. In fact, patients with hyperoxemia are typically asymptomatic unless oxygen toxicity develops over a prolonged period, which is not consistent with these acute symptoms.
B. Hypercapnia: Elevated CO2 levels typically cause symptoms such as headache, flushed skin, drowsiness, and eventually lethargy. Although confusion can occur, hypercapnia usually leads to hypoventilation rather than tachypnea.
C. Alkalosis: Alkalosis, particularly respiratory alkalosis, can cause lightheadedness and paresthesia but rarely leads to confusion and significant anxiety unless it is severe. The described symptoms more strongly suggest low oxygen levels rather than an altered pH state.
D. Hypoxemia: Low oxygen levels in the blood stimulate the respiratory center, resulting in tachypnea as the body attempts to increase oxygen intake. Anxiety and confusion occur as cerebral oxygenation decreases, making hypoxemia the most likely cause of these findings.
Correct Answer is A
Explanation
A. That the patient has an elevated carbon dioxide (CO2) level: Hypercapnia refers specifically to an increased PaCO2 in the blood, usually resulting from hypoventilation or impaired gas exchange. It can lead to respiratory acidosis if not corrected.
B. That the patient has an elevated oxygen (O2) level: Elevated oxygen is called hyperoxemia, not hypercapnia.
C. That the patient has an elevated bicarbonate level (HCO3): Bicarbonate may rise as a compensatory response to chronic hypercapnia, but hypercapnia itself refers to CO2, not HCO3.
D. That the patient has an oxygen saturation (SpO2) level of 100%: SpO2 measures oxygen saturation and does not indicate carbon dioxide levels. A patient can be hypercapnic even with normal or high SpO2.
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