Which drainage change should the nurse assess and report regarding chest tube drainage after CABG?

• A. A change in the color of the drainage from dark to bright red
• B. Drainage stops completely
• C. Sustained hemorrhage-drainage amount that is not declining over time
• D. Drainage becomes pink and watery

Answer: (C)

After CABG, chest tube drainage is watched closely for signs of postoperative bleeding. The best indicator of a problem is drainage that remains heavy and does not decline over time, signaling ongoing hemorrhage in the mediastinal space. Ongoing bleeding can lead to rapid blood loss, hemodynamic instability, and cardiac tamponade, so this finding requires immediate assessment and intervention by the surgical team, along with ensuring the tube is patent and monitoring vitals and labs.

A change to bright red drainage can be expected early as fresh blood is shed, but if the amount is decreasing or stable, it isn’t as alarming. If drainage stops completely, this might suggest a blockage or clotting in the tube rather than no bleeding, which also needs attention but is a different concern. Pink and watery drainage suggests serous fluid and is typically less concerning if the overall drainage is decreasing.