— 生理適應 · MEDIUM · SATA —
一位肺葉切除術後置放胸管的病人，在水封瓶（water-seal chamber）的評估中，下列哪項發現是預期之內的？（選所有適合的）
A nurse is caring for a client with a chest tube following a lobectomy. Which findings are expected during the assessment of the water-seal chamber? (Select all that apply.)
- AContinuous bubbling in the water-seal chamber水封瓶內持續冒泡
- BFluctuation (tidaling) of the fluid level with respiration✓ 正解液面隨呼吸波動（潮汐現象）
- CAbsence of bubbling during inhalation and exhalation✓ 正解吸氣和呼氣時無冒泡現象
- DThe fluid level rises during inspiration and falls during expiration✓ 正解液面在吸氣時上升，呼氣時下降
- EPresence of a small air leak indicator存在少量氣漏指示
— Explanation · 中文詳解 —
胸管水封瓶的正常運作機制包括潮汐現象（tidaling），即隨呼吸運動而水位波動。吸氣時胸內負壓增加，水面上升；呼氣時壓力下降，水面下降。若無氣漏，水封瓶內不應有持續性氣泡，因為持續性氣泡代表肺部或裝置有漏氣。若完全靜止，則需檢查管路是否有阻塞。
Expected findings in a water-seal chamber include tidaling, where the fluid level fluctuates with respiration due to changes in intrapleural pressure. Specifically, the fluid rises during inspiration and falls during expiration. Continuous bubbling is abnormal and indicates an air leak, whereas the absence of bubbling is normal unless air is actively being evacuated.
✦ 台美臨床差異
美國護理師常負責胸管護理與拔管評估；台灣通常由醫師操作拔管，護理師負責協助與術後照護監測。