A nurse is caring for a patient who has a closed chest drainage system (underwater seal) for a traumatic pneumothorax. While checking the system, the nurse observes continuous, vigorous bubbling in the water-seal chamber. What does continuous bubbling in the water seal indicate?

Answer and explanation

Correct answer: C. A persistent air leak in the chest drainage system or thoracic cavity

  1. Step 1: In a chest tube drainage system, intermittent bubbling in the water-seal chamber during expiration or coughing is expected while an air leak resolves.
  2. Step 2: Continuous bubbling throughout both inspiration and expiration indicates an active air leak, either within the patient's pleural space (e.g., bronchopleural fistula) or from a loose connection/crack in the external drainage tubing.
Answer
A persistent air leak in the chest drainage system or thoracic cavity.
Why not the others: 'Normal expected functioning' is intermittent bubbling, not continuous bubbling; 'Complete resolution' is indicated by zero bubbling and stable lung re-expansion on X-ray; 'Fluid accumulation' is tracked in the collection chamber, not by bubbling in the water seal.

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