Asked by Sierra Harrison on Jun 11, 2024
Verified
Of the following nursing assessments,which should be reported to the primary care provider immediately by the nurse?
A) Bloody drainage from a patient with a hemothorax
B) Subcutaneous emphysema is noted on assessment.
C) Bubbling in the water seal stops on a patient with a pneumothorax.
D) Over 300 mL of drainage has been collected in the system in the past hour.
Subcutaneous Emphysema
The presence of air or gas in the subcutaneous layer of the skin, often resulting from injury or surgery.
Primary Care Provider
A healthcare professional who acts as a first point of consultation for all patients within the health care system.
- Discern and manage critical conditions pertinent to individuals with chest tubes, such as tension pneumothorax.
- Detect issues revealed by anomalous drainage from a chest tube.
Verified Answer
DC
Donna CarrollJun 17, 2024
Final Answer :
D
Explanation :
Drainage exceeding 100 mL/hr should be reported immediately because this would be considered abnormal.Drainage would be expected to be bloody if the patient has a hemothorax.Cessation of bubbling in the water seal indicates that the air has been evacuated in the patient with a pneumothorax.Although the finding of subcutaneous emphysema should be reported,documented,and monitored,it is not an emergency.
Learning Objectives
- Discern and manage critical conditions pertinent to individuals with chest tubes, such as tension pneumothorax.
- Detect issues revealed by anomalous drainage from a chest tube.