護理師照顧放置胸腔引流管的病人，下列哪項是正確的護理措施？
A nurse is caring for a client with a chest tube drainage system. What is the appropriate nursing action?
- AIncrease suction pressure if bubbles are seen in the water seal chamber若在水封瓶內看到氣泡，則增加抽吸壓力
- BClamp the chest tube if the system needs to be changed若需更換系統，則夾住胸管
- CStrip the tubing to clear clots every hour每小時擠壓管路以清除血塊
- DEnsure the drainage system remains below the level of the client's chest✓ 正解確保引流系統位於病人胸部下方
胸腔引流系統（Chest tube drainage system）利用水封瓶（Water seal）原理，確保氣體或積液只能單向排出，防止空氣逆流回胸腔。引流瓶必須始終維持在胸腔水平以下（D），這是利用重力引流的物理原則，若高於胸腔，液體會逆流，導致肺部塌陷或嚴重感染。夾管（B）具有高風險，若意外夾住且病人仍有氣胸，會引發張力性氣胸（Tension pneumothorax）。擠壓管路（C）會造成胸腔內壓力瞬間劇烈變化，應儘量避免。氣泡（A）在水封瓶中若持續出現，代表漏氣，應查找漏氣點而非盲目增加負壓。
A chest tube drainage system uses the water seal principle to ensure that air or fluid drains in only one direction, preventing air from flowing back into the chest. The drainage unit must always be kept below the level of the client's chest (D); this applies the physical principle of gravity drainage, since if the unit is raised above the chest, fluid can flow back and lead to lung collapse or serious infection. Clamping (B) carries high risk: if the tube is inadvertently clamped while the client still has a pneumothorax, a tension pneumothorax can result. Stripping the tubing (C) causes abrupt, severe changes in intrathoracic pressure and should be avoided. Persistent bubbling in the water seal (A) signals an air leak; the source of the leak should be sought rather than blindly increasing suction.