If the water seal of a chest tube breaks, what should the nurse do next after clamping it?

In the scenario where the water seal of a chest tube breaks, the next critical step is to establish a new water seal to maintain proper functioning of the pleural drainage system. Placing the tube underwater is the correct action because it creates a temporary seal that prevents air from entering the pleural space and helps to ensure that the chest tube continues to function properly until further interventions can be implemented.

Creating an underwater seal effectively mimics the original system’s function by allowing air to escape but preventing air from entering the pleural cavity, which is crucial for maintaining lung inflation and preventing a tension pneumothorax. This is a key immediate response that prioritizes patient safety and the integrity of the thoracic drainage system.

Other actions, while potentially important, would not resolve the immediate issue of the broken water seal nor provide a new seal quickly enough. For instance, notifying the physician or inspecting the tube for damage may be necessary following the establishment of a temporary underwater seal, but these do not directly address the urgent need to restore function and protect the patient from complications.