After insertion of a chest tube for a pneumothorax, a client becomes hypotensive with neck vein distention, tracheal shift, absent breath sounds, and diaphoresis. Nurse Amanda suspects a tension pneumothorax has occurred. What cause of tension pneumothorax should the nurse check for?
A. Infection of the lung
B. Kinked or obstructed chest tube
C. Excessive water in the water-seal chamber
D. Excessive chest tube drainage
Correct Answer: B. Kinked or obstructed chest tube
Kinking and blockage of the chest tube is a common cause of a tension pneumothorax.
Option A: Infection of the lung won’t cause a tension pneumothorax. A tension pneumothorax is a life-threatening condition that develops when air is trapped in the pleural cavity under positive pressure, displacing mediastinal structures and compromising cardiopulmonary function.
Option C: Excessive water won’t affect the chest tube drainage. The main purpose of the water seal is to allow air to exit from the pleural space on exhalation and prevent air from entering the pleural cavity or mediastinum on inhalation.
Option D: An excessive chest tube drainage cannot cause tension pneumothorax. Chest tubes drain blood, fluid, or air from around the lungs, heart, or esophagus. The tube around the lung is placed between the ribs and into the space between the inner lining and the outer lining of the chest cavity.