— 生理適應 · MEDIUM · MCQ —
護理師照護一位放置胸管的病人，評估時發現水封瓶持續有氣泡冒出。下列何者為正確的臨床判斷？
A nurse is caring for a client with a chest tube. Upon assessment, the nurse notes continuous bubbling in the water seal chamber. Which clinical interpretation is correct?
- AThe lung has successfully re-expanded肺部已成功復張
- BThe suction pressure is too high吸氣壓力過高
- CThe chest tube has an air leak✓ 正解胸管有漏氣
- DThe system is functioning normally系統運作正常
— Explanation · 中文詳解 —
水封瓶（Water seal chamber）在正常情況下應隨著呼吸週期有波動，若出現持續氣泡（Continuous bubbling），通常意味著胸腔內持續漏氣，或是胸管系統本身氣密性不佳。若病人已拔除胸腔氣體，氣泡應停止，因此持續冒泡是不正常的徵象，需檢查連接處密封性。
Continuous bubbling in the water seal chamber indicates an air leak within the chest tube system or from the pleural space, which is abnormal. Normal function involves intermittent bubbling during expiration or coughing, whereas lung re-expansion results in the cessation of air bubbles.
✦ 台美臨床差異
美台皆強調胸管護理的氣密性檢查與評估，但台灣對於持續氣泡的處置更強調需先排除管路連接問題。