— 降低風險 · HARD · SATA —
護理師評估一位放置胸管的病人，下列哪些發現顯示可能出現併發症？（選所有適合的）
A nurse is assessing a client with a chest tube. Which findings indicate a potential complication? (Select all that apply.)
- AContinuous bubbling in the water seal chamber✓ 正解水封瓶內持續冒泡
- BSubcutaneous emphysema near the insertion site✓ 正解插入部位附近皮下氣腫
- COscillation of fluid in the water seal tube with respirations呼吸時水封管內液體波動
- DSudden decrease in chest tube drainage output✓ 正解胸管引流液突然減少
- ETracheal deviation toward the unaffected side✓ 正解氣管向未患側偏移
— Explanation · 中文詳解 —
胸管系統若發生持續氣泡，通常暗示系統漏氣。皮下氣腫代表氣體由胸膜腔滲入皮下，為嚴重併發症。引流量突然減少可能提示管路阻塞。氣管偏移則暗示張力性氣胸，屬緊急狀態。波動（Oscillation）則為正常呼吸同步現象。
Continuous bubbling in the water seal chamber suggests an air leak in the system. Subcutaneous emphysema indicates air escaping into surrounding tissues, while a sudden decrease in drainage may signal tube obstruction. Tracheal deviation toward the unaffected side is a classic sign of tension pneumothorax, whereas oscillation with respirations is a normal finding.
✦ 台美臨床差異
美國 ICU 常使用數位胸腔引流系統；台灣則多使用傳統水封瓶，兩者對於漏氣的偵測方式與警報設定有所差異。