A chest tube with suction is placed in a client with lung cancer following a lobectomy. Which nursing observation should be reported to the physician? A. Clots in the tubing during the first 24 hours B. Subcutaneous emphysema on the second postoperative day C. Decreased bubbling in the water seal D. Bloody fluid in the drainage collection chamber in the first 24 hours

A chest tube with suction is placed in patients to remove air, blood, or fluid from the pleural space, in this case following a lobectomy. The main goal is to restore lung function and facilitate post-operative recovery.

A: Clots in the tubing during the first 24 hours - It is common to have some clots in the tubing following the surgery as long as they don't completely block the drainage system. B: Subcutaneous emphysema on the second postoperative day - The presence of air trapped in the subcutaneous tissue indicates a leak in the air seal. This is a complication and should be reported to the physician. C: Decreased bubbling in the water seal - Decreased bubbling means that the negative pressure created by the suction system is working properly, and can be a sign of lung re-expansion. D: Bloody fluid in the drainage collection chamber in the first 24 hours - This is expected, as there may be some bleeding following the lobectomy, which should decrease over time.

The correct answer is B: Subcutaneous emphysema on the second postoperative day. It is essential to report this observation because it indicates an air leak in the chest tube system, potentially leading to complications and delayed recovery.