Question

While assessing a client with a three-chamber chest drainage system, the nurse observes that the fluid level in the second chamber does not fluctuate. What is the appropriate action for the nurse to take at this time? A. Determine if the suction is working properly B. Empty the fluid from the second chamber C. Call the doctor and prepare to change systems D. Increase the amount of suction applied

Short answer

Answer: A. Determine if the suction is working properly

Step-by-step solution

Background on Three-chamber Chest Drainage System

A three-chamber chest drainage system is used in a medical setting to remove air, blood, and fluid from the pleural space for people who have had surgery, an injury or an illness affecting the chest. The drainage system has three main parts: the collection chamber, the water seal chamber, and the suction control chamber.

Collection Chamber

The first chamber, the collection chamber, collects fluid and blood from the patient. The nurse should observe and measure fluid here regularly.

Water Seal Chamber (Second Chamber)

The second chamber, the water seal chamber, acts as a one-way valve to prevent air from flowing back into the patient's chest. The fluid level in this chamber normally fluctuates with the patient's breathing (tidaling). If the fluid level in the water seal chamber does not fluctuate, it may indicate a problem with the suction system or an obstruction in the pleural space.

Suction Control Chamber

The third chamber, the suction control chamber, regulates the amount of suction applied to the pleural space. The amount of suction can be adjusted as needed.

Analyzing the Options

Given the information about the three-chamber chest drainage system, we can now analyze the available options: A. Determine if the suction is working properly - This is a potential correct answer, as a problem in the suction system can cause the fluid level in the water seal chamber not to fluctuate. B. Empty the fluid from the second chamber - This option is incorrect because emptying fluid from the water seal chamber would disrupt the one-way valve mechanism, potentially allowing air to flow back into the patient. C. Call the doctor and prepare to change systems - This option seems too drastic and should not be the initial response. The nurse should first check if the suction is working properly before considering replacing the entire system. D. Increase the amount of suction applied - This option is also incorrect. Increasing the suction without first ensuring that the suction system is working properly can cause harm to the patient.

Conclusion

Therefore, the appropriate action for the nurse to take in this situation is: A. Determine if the suction is working properly.