When Chest Tube Drainage Signals a Problem

Respiratory · Question from the ATI RN Medical-Surgical 2023 Proctored Exam study set

Correct answer: C. Notify the surgeon

Why this is the answer

Drainage above roughly 70–100 mL/hr is considered excessive and can signal active post-operative bleeding, so the surgeon needs to know right away. Documenting the amount (A) is necessary but not sufficient on its own — documentation without escalation delays the response to a potential hemorrhage. Milking the tubing (B) is an outdated technique that can create dangerous negative-pressure spikes in the pleural space and doesn't address the underlying cause of the bleeding. Decreasing the suction (D) doesn't stop or evaluate the hemorrhage; it only changes how the drainage system is pulling, not why the patient is bleeding.

The bigger concept

Chest tube output is one of the few numbers nurses track almost minute-to-minute post-op precisely because a sudden spike can mean surgical bleeding — knowing the normal-vs-excessive threshold (roughly 100 mL/hr as a red flag) is what turns a raw number into a clinical decision.

Related Respiratory practice questions

• The Gold-Standard Test for a Pulmonary Embolism
• Interpreting an ABG in a COPD Exacerbation
• What a V/Q Scan Actually Measures
• Chest Tube 'Tidaling' in the Water-Seal Chamber
• Subcutaneous Emphysema Around a Chest Tube Site

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