護理師照護胸管病患，哪些徵象需立即通知醫師？（選所有適合的）
A nurse is caring for a client with a chest tube. Which finding requires immediate notification of the provider? (Select all that apply.)
- AContinuous bubbling in the water seal chamber✓ 正解水封瓶內持續冒泡
- BSudden decrease in chest tube drainage✓ 正解胸管引流突然減少
- CPain at the insertion site置管處疼痛
- DTracheal deviation✓ 正解氣管偏移
- EFluctuation of fluid in the water seal chamber水封瓶內液面波動
胸管系統的運作需維持密閉與負壓。A. 持續性氣泡暗示系統漏氣或肺部有大規模氣漏，需立即處理；B. 引流量驟減可能因管路阻塞或扭曲，影響引流效果；D. 氣管偏移是張力性氣胸（Tension Pneumothorax）的晚期致命徵兆，暗示氣壓造成縱隔腔移位。C. 傷口疼痛為術後常見反應，非立即生命威脅；E. 水封瓶隨呼吸波動（Tidaling）是管路通暢且未被壓迫的正常生理現象。
A chest tube system must remain closed and under negative pressure. A. Continuous bubbling indicates a system leak or a large air leak from the lung and requires immediate attention. B. A sudden drop in drainage may indicate obstruction or kinking of the tubing, impairing drainage. D. Tracheal deviation is a late and life-threatening sign of tension pneumothorax, indicating mediastinal shift due to air pressure. C. Wound pain is a common postoperative reaction, not an immediate threat to life. E. Tidaling in the water-seal chamber with respiration is a normal finding that indicates the tubing is patent and uncompressed.
台美臨床原則一致，皆以 ABC（Airway, Breathing, Circulation）為優先考量。對於胸管護理，美方護理師更嚴格要求若發現持續性氣泡，應依照機構政策（Policy）先檢查連接處，若持續存在則立即通知醫師，強調「即時評估」的重要性。