A nurse is planning care for a client who has a chest drainage system set to low suction following a thoracotomy. Which of the following actions should the nurse include in the plan of care?

Nursing care for a client with a chest drainage system after a thoracotomy focuses on maintaining effective removal of air and fluid from the pleural space while ensuring lung re-expansion. A chest tube system relies on gravity and water seal mechanisms to prevent air from re-entering the pleural cavity. Continuous assessment of system function is essential to detect air leaks, obstruction, or improper drainage. Proper management helps prevent complications such as pneumothorax or impaired ventilation. Rationale: A. Emptying the collection chamber every 8 hours is not routinely required unless the drainage volume reaches a specified level or per facility protocol. The system is designed to collect fluid safely, and unnecessary emptying may disrupt measurement accuracy and sterility. Drainage should be recorded and the system maintained according to prescribed guidelines. B. Keeping the water seal chamber at chest level is incorrect because the drainage system must always be kept below the level of the chest to allow gravity drainage. If positioned at chest level, fluid may flow back into the pleural space, increasing the risk of infection and impaired lung expansion. Proper positioning ensures effective drainage and prevents complications. C. Looping excess tubing below the chest wall is incorrect because dependent loops can cause fluid accumulation and obstruction of drainage flow. This may lead to impaired evacuation of air or fluid and increase intrathoracic pressure. Tubing should be kept straight and free of kinks to maintain patency of the system. D. Checking for bubbling in the water seal chamber is appropriate because intermittent bubbling may indicate air escaping from the pleural space, especially during expiration or coughing after thoracotomy. Continuous bubbling, however, may indicate an air leak in the system that requires further assessment. Monitoring bubbling helps evaluate the integrity and function of the chest drainage system.