🧠 Chest Tube Nursing Care for NCLEX: Key Concepts, Troubleshooting, and Mnemonics

Chest tubes can look intimidating—but they don’t have to be. The NCLEX wants to know whether you can:

• Recognize what’s normal vs dangerous

• Respond fast to air leaks, dislodgement, or subcutaneous emphysema

• Know when to notify the provider vs when to act independently

🚨 Chest Tube System Overview

Section	What It Does	Normal Findings
Collection Chamber	Receives drainage from the chest	Serosanguinous, <100 mL/hr
Water Seal Chamber	Prevents air from re-entering the pleural space	Tidaling with breathing, no continuous bubbling
Suction Control	Controls the amount of suction applied via water	Gentle bubbling if suction is active

⚠️ Troubleshooting Chest Tubes

🚨 Bubbling in Water Seal

• Continuous bubbling = air leak ✅

• Intermittent bubbling during cough = normal

Clamp to locate leak → check connections → notify provider if persistent.

🚫 No Tidaling

• Could indicate lung re-expansion or tube blockage

Check for kinks, reposition patient, notify if unresolved.

💥 Disconnection or Dislodgement

• If disconnected: Place tube in sterile water until new system arrives

• If pulled out: Apply sterile petroleum gauze, tape 3 sides, call HCP

🎯 Mnemonic: "STOP for Chest Tubes"

• S – Site (check dressing, sutures, bleeding)

• T – Tubing (no kinks, dependent loops)

• O – Output (color, quantity, consistency)

• P – Patency (tidaling, air leaks, suction on)

📝 NCLEX Practice Question

A nurse notes continuous bubbling in the water seal chamber. What is the correct action?

• A. Clamp the chest tube at the insertion site

• B. Notify the provider immediately ✅

• C. Lower the suction level

• D. Encourage deep breathing

Rationale: Continuous bubbling indicates an air leak. The nurse should troubleshoot, but provider notification is essential.

🧬 Before You Go…

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• 1000+ high-yield visuals

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• Real-world test readiness

🚀 Call to Action

✅ Try chest tube scenarios in the Qbank → kingofthecurve.org/trial-sessions
✅ Grab your free lifetime visual deck → kingofthecurve.org/free-lifetime
✅ Challenge yourself on today’s QOTD → kingofthecurve.org/qotd

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