The nurse is caring for a patient with a chest tube. During her rounds, the nurse considers that the chest tube is working properly if she observes:


• Intermittent bubbling is expected in the water-seal chamber. If bubbling is increased or becomes rapid, it may indicate an air leak in the closed drainage system. Rapid bubbling may also indicate a considerable loss of air due to a tear or incision in the pleura.

• Fluid in the water-seal chamber must fluctuate during respiration. This is called tidaling. When tidaling stops, the chest tube might be kinked or obstructed.

• Fluid in the suction chamber should bubble gently.  If there is no bubbling, check to see if the suction tubing is connected and the suction source turned on. 

Visit our website for other NCLEX topics now!