What symptom should a client with a chest tube be instructed to report to the physician?

A client with a chest tube should be instructed to report continuous bubbling in the water-seal chamber because this symptom can indicate an air leak in the system. In a properly functioning chest tube setup, intermittent bubbling may be observed when a patient exhales, coughs, or takes a deep breath; however, continuous bubbling suggests that air is escaping from the pleural space or there is a disconnection in the system. This can lead to reduced effectiveness of the chest tube in re-establishing normal intrathoracic pressure and can cause complications like pneumothorax or further lung collapse.

It’s important to monitor the water-seal chamber closely as its function is crucial in preventing air from entering the pleural cavity. Detection of a continuous flow of bubbles warrants immediate evaluation by a physician to determine the source of the air leak and to implement necessary corrective measures, making it a critical observation for the patient’s care.

Other symptoms such as a respiratory rate greater than 16 breaths per minute may be normal depending on the patient’s condition, and fluctuations of fluid in the water-seal chamber are expected as they reflect respiratory effort and changes in intrathoracic pressure. Fluid in the chest tube might also be considered a normal part of the drainage process