一位裝設胸腔引流管的病人，護理師觀察到水封瓶內的波動突然停止。護理師應首先進行何項評估？
A nurse is caring for a client with a chest tube who experiences a sudden decrease in tidal fluctuations. Which assessment should the nurse perform first?
- AIncrease the suction pressure增加抽吸壓力
- BCheck for kinks in the tubing✓ 正解檢查管路是否有打折
- CAuscultate breath sounds聽診呼吸音
- DObserve for subcutaneous emphysema觀察是否有皮下氣腫
胸腔引流管（Chest tube）的水封瓶波動（Tidal fluctuations）反映胸腔內壓力變化，若突然停止，需評估是否存在機械性阻塞。護理思路應遵循 ABC 原則，先排除最簡單且致命的機械因素。第一時間檢查管路有無扭曲、壓迫或阻塞（如被病人壓住），這是恢復引流最快且最安全的方法。若排除物理性問題，才需進一步評估呼吸音等臨床狀況，以排除肺部擴張不全或氣胸復發的可能性。
Tidal fluctuations in the water seal chamber of a chest tube reflect changes in intrathoracic pressure; if they stop abruptly, mechanical obstruction must be evaluated. Nursing reasoning should follow the ABC principle, first ruling out the simplest yet potentially lethal mechanical cause. The first step is to check the tubing for kinks, compression, or obstruction (such as the client lying on it); this is the fastest and safest way to restore drainage. Only if physical problems have been ruled out should the nurse then assess breath sounds and other clinical findings to rule out atelectasis or recurrent pneumothorax.
台美臨床對於胸腔引流管的護理原則一致，均強調「檢查管路暢通性」為第一優先順序，並嚴禁在未經醫師指示下擅自擠壓管路（Milking/Stripping），以免造成胸腔內壓力瞬間劇變導致組織損傷。