A nurse is caring for a client who is 24 hours post-thoracotomy with a chest tube connected to a closed drainage system set to -20 cm suction. The nurse notes the following: Respiratory rate: 22/min, SpO2: 94 The client denies shortness of breath but reports mild incisional pain. Which action should the nurse take?

This scenario assesses management of post-thoracotomy chest tubes and stable respiratory findings. Knowledge of pleural space physiology, normal post-operative healing, and chest tube safety protocols is required to differentiate between expected recovery milestones and critical complications requiring urgent intervention. Choice A rationale Clamping chest tubes is contraindicated unless specifically checking for leaks or changing the drainage system. It risks tension pneumothorax by trapping air or fluid within the pleural space, which can lead to mediastinal shift and cardiovascular collapse. Choice B rationale Suction is typically maintained at -20 cm H2O to facilitate lung re-expansion. Increasing suction without a provider order can cause tissue trauma or exacerbate air leaks. The current respiratory rate and oxygen saturation indicate effective drainage and ventilation. Choice C rationale Bubbling in the water seal chamber indicates an air leak, but the current clinical data does not suggest one. A respiratory rate of 22 and 94 percent saturation are common 24 hours post-surgery while recovering from anesthesia. Choice D rationale Stable vital signs and manageable incisional pain are expected findings. Continuing to monitor ensures the lung remains expanded and the drainage system functions correctly. The SpO2 of 94 percent is acceptable during the early recovery phase after thoracotomy.