A patient post-right upper lobectomy has constant bubbling in the water seal chamber. What should the nurse check first?

In the scenario following a right upper lobectomy, the presence of constant bubbling in the water seal chamber of the chest tube system indicates a potential air leak or that the chest tube is not functioning as intended. Checking the chest tube connections is the most critical initial action because it helps determine if the bubbling is due to a disconnect or malfunction in the system.

If the connections are loose or dislodged, it can compromise the integrity of the chest tube system, leading to inadequate lung re-expansion and potentially risking further complications for the patient. Ensuring that all connections are secure may resolve the issue without necessitating further interventions or assessments.

While assessing lung sounds, vital signs, and the amount of drainage are important components of the patient's overall evaluation, addressing the potential source of the bubbling first—by ensuring the chest tube is properly connected and functioning—is essential for patient safety and effective management of their recovery. Thus, prioritizing the check of the chest tube connections is appropriate in this situation.