A client with an electrical burn is brought to the emergency department. The entrance wound is on the right hand and the exit wound is on the left foot.
The client reports chest tightness and feels lightheaded. Which action should the nurse take?

The nurse must utilize knowledge of thoracic drainage mechanics and equipment troubleshooting. A three-chamber system requires consistent suction to maintain negative pleural pressure. Identifying the cause of suction failure involves systematic assessment of the external vacuum source and tube integrity.

Choice A rationale

Suction control chambers in wet systems require active external suction to function. Bubbling indicates vacuum application. Verifying the regulator is on ensures the system has the mechanical force necessary to maintain the ordered negative pressure for lung re-expansion.

Choice B rationale

Milking or stripping chest tubes creates high levels of negative pressure that can damage delicate lung tissue. This practice is generally contraindicated unless specifically ordered by a surgeon, as it increases the risk of pleural trauma and tension pneumothorax.

Choice C rationale

Absence of bubbling in the suction control chamber of a wet system is an abnormal finding. It signifies a lack of active suctioning. The nurse cannot ignore this, as effective pleural drainage depends on continuous atmospheric pressure regulation.

Choice D rationale

While water levels dictate suction intensity, adding water will not resolve a lack of bubbling if the suction source is off. Bubbling is caused by air passing through water via the suction regulator, not the volume itself.

Discharge teaching for post-radiation brain tumor patients requires understanding oncology and pharmacology. Knowledge of medication adherence, symptom monitoring for increased intracranial pressure, and integumentary protection is needed. Identifying misconceptions ensures patient safety and prevents potential neurological relapse or secondary injury.

Choice A rationale

Abrupt cessation of medications, especially anticonvulsants or steroids used in neuro-oncology, can trigger rebound edema or seizures. Maintaining therapeutic blood levels is critical for managing potential complications after radiation therapy has concluded to ensure neurological stability.

Choice B rationale

Headaches and visual disturbances are primary indicators of increased intracranial pressure or tumor recurrence. Patients must recognize these signs as urgent neurological changes that require immediate medical evaluation to prevent brain herniation or permanent functional loss.

Choice C rationale

Radiation therapy damages the DNA of skin cells, leading to thinning and increased sensitivity. Protecting the scalp from ultraviolet radiation prevents severe dermatitis and secondary burns on tissue that already has compromised healing capabilities.

Choice D rationale

Gradual reintegration into daily life is standard post-treatment advice. While energy levels dictate activity, resuming normal routines as tolerated is appropriate, provided the patient avoids hazardous activities if they have residual neurological deficits or seizure risks.