Page 2428 - Saunders Comprehensive Review For NCLEX-RN

O. Chest Tube Drainage System

1. The chest tube drainage system returns negative
pressure to the intrapleural space.
2. The system is used to remove abnormal accumulations
of air and fluid from the pleural space (Fig. 69-12).
3. Drainage collection chamber (Fig. 69-13)
a. The drainage collection chamber is
located where the chest tube from the
client connects to the system.
b. Drainage from the tube drains into and
collects in a series of calibrated
columns in this chamber.
4. Water seal chamber (see Fig. 69-13)
a. The tip of the tube is underwater,
allowing fluid and air to drain from
the pleural space and preventing air
from entering the pleural space.
b. Water oscillates (moves up as the client
inhales and moves down as the client
exhales).
c. Excessive bubbling indicates an air leak
in the chest tube system.
5. Suction control chamber (see Fig. 69-13)
a. The suction control chamber provides
the suction, which can be controlled to
provide negative pressure to the chest.
b. This chamber is filled with various
levels of water to achieve the desired
level of suction; without this control,
lung tissue could be sucked into the
chest tube.
c. Gentle bubbling in this chamber
indicates that there is suction and does
not indicate that air is escaping from
the pleural space.
6. Dry suction system (see Fig. 69-13)
a. This is another type of chest drainage
system. Because this is a dry suction
system, absence of bubbling is noted in
the suction control chamber.
b. A knob on the collection device is used
to set the prescribed amount of
suction; then the wall suction source
dial is turned until a small orange
floater valve appears in the window on
the device (when the orange floater
valve is in the window, the correct

2428