Saunders Respiratory Practice

What is the method used to monitor for crepitus in a client with a chest tube?

1. Listening for a wheezing sound

2. Observing for a respiratory rate increase

3. Palpating for a crackling sensation

4. Checking for skin color change

The correct answer is: Palpating for a crackling sensation

Monitoring for crepitus, which is the presence of air in the subcutaneous tissue, commonly involves palpating for a crackling sensation under the skin. This sensation occurs when air escapes from the lung or intrathoracic space and enters the tissues, creating pockets of air that can be felt when pressure is applied. Palpation is the most direct and reliable way to detect crepitus, as it allows healthcare providers to assess the texture and feel of the skin and underlying tissues. This method is especially relevant in patients with a chest tube, as crepitus can indicate complications such as a pneumothorax or air leak. In contrast, listening for wheezing assesses airflow in the bronchi and indicates bronchospasm but does not specifically detect crepitus. Observing for an increased respiratory rate can suggest distress or other respiratory issues, but it is not specific for detecting crepitus. Checking for skin color change may reveal underlying issues such as hypoxia or poor perfusion but does not provide direct information about the presence of crepitus. Therefore, palpating for a crackling sensation is the most appropriate method to monitor for crepitus in a client with a chest tube.