A client has a chest tube attached to a waterseal drainage system and the nurse notes that the fluid in the chest tube and in the water-seal column has stopped fluctuating. The nurse should determine that:
1. The lung has fully expanded.
2. The lung has collapsed.
3. The chest tube is in the pleural space.
4. The mediastinal space has decreased.
Answer: 2.The lung has collapsed.
Instability of fluid in a water-seal drainage system for the chest tubes implies that at least there is still air and fluids leaving pleural space. This implies that the lung is at least partially inflated.
As the fluid ceases to oscillate and becomes inactive, it shows that air is no longer venting out from the pleural space through chest tube. This implies that the lung has probably collapsed or that tube is blockage.
The absence of pulsations indicates that the pleural pressure has been equalized to atmospheric level, leading to collapse lung. It does not reflect a full lung opening, correct position of the chest tube or alterations in mediastinal space .
Thus, if the nurse observes that fluid does not fluctuate anymore in a water-seal system and it has collapsed. This indicates an evil that demands early evaluation and treatment.
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