The nurse is caring for a patient with a closed-chest drainage ...

[go.lag]

The nurse is caring for a patient with a closed-chest drainage system with chest tubes. Which observation confirms that the system is intact and working?
 
  a. The water level in the water-seal chamber fluctuates.
  b. The level of fluid in the collection cham-ber rises.
  c. There are constant bubbles in the wa-ter-seal chamber.
  d. The suction has been attached.

Question 2

The nurse is planning care for the patient who is on a protocol of bleomycin. Since bleomycin is an antitumor antibiotic, which intervention should the nurse add to the care plan?
 
  a. Assess hearing acuity.
  b. Measure urinary output.
  c. Weigh daily to assess fluid retention.
  d. Monitor for cardiac arrhythmias.

[blfontai]

Answer to Question 1

A
If the level of the water in the water-seal chamber rises and falls with the patient's respiration, the system is intact. Constant bubbles in the water-seal chamber indicate a leak in the system. The fluid in the collection container drains by gravity whether the closed-chest drainage system is intact or not. Suction is not significant with respect to whether the system is intact.

Answer to Question 2

D
Bleomycin is cardiotoxic and can cause cardiac arrhythmias; therefore, this would be the highest priority intervention. Chemotherapies that are ototoxic would warrant a hearing test; urinary output and fluid retention should be assessed with most chemotherapy drugs, and especially for those that are nephrotoxic.