chest trauma and pneumothorax Flashcards
A patient is admitted with a chest wound and experiencing extreme dyspnea, tachycardia, and hypoxia. The chest wound is located on the left mid-axillary area of the chest. On assessment, you note there is unequal rise and fall of the chest with absent breath sounds on the left side. You also note a “sucking” sound when the patient inhales and exhales. The patient’s chest x-ray shows a pneumothorax. What type of pneumothorax is this known as?*
A. Closed pneumothorax
B. Open pneumothorax
C. Tension pneumothorax
D. Spontaneous pneumothorax
B
In regards to the patient in the question above, which of the following options below is a nursing intervention you would provide to this patient?*
A. Place the patient in supine position
B. Place a non-occlusive dressing over the chest wound
C. Place a sterile occlusive dressing over the chest wound and tape it on three sides
D. Prepare the patient for a thoracentesis
C
A patient is diagnosed with a primary spontaneous pneumothorax. Which of the following is NOT a correct statement about this type of pneumothorax?*
A. It can be caused by the rupture of a pulmonary bleb.
B. It can occur in patients who are young, tall and thin without a history of lung disease.
C. Smoking increases the chances of a patient developing a spontaneous pneumothorax.
D. It is most likely to occur in patients with COPD, asthma, and cystic fibrosis.
D
Which of the following is a LATE sign of the development of a tension pneumothorax?*
A. Hypotension
B. Tachycardia
C. Tracheal deviation
D. Dyspnea
C
While caring for a patient with a suspected pneumothorax, you note there are several areas on the patient’s skin that appear to be “bulging” out. These “bulging” areas are located on the patient’s neck, face, and abdomen. On palpation on these areas, you note they feel “crunchy”. When charting your findings you would refer to this finding as?*
A. Subcutaneous paresthesia
B. Pigment molle
C. Subcutaneous emphysema
D. Veisalgia
C
You’re providing care to a patient with a pneumothorax who has a chest tube. On assessment of the chest tube system, you note there is no fluctuation of water in the water seal chamber as the patient inhales and exhales. You check the system for kinks and find none. What is your next nursing action?*
A. Keep monitoring the patient because this is a normal finding.
B. Increase wall suction to the system until the water fluctuates in the water seal chamber.
C. Assess patient’s lung sounds to assess if the affected lung has re-expanded.
D. Notify the physician.
C
A patient is receiving mechanical ventilation with PEEP. The patient had developed a tension pneumothorax. Select ALL the signs and symptoms that can present with this condition:*
A. Hypotension
B. Jugular Venous Distention
C. Bradycardia
D. Tracheal deviation
E. Hyperemia
F. Tachypnea
A B D F
A patient has a chest tube for treatment of a pneumothorax in the left lung. Which finding during your assessment requires immediate nursing intervention?*
A. The water seal chamber has intermittent bubbling.
B. The patient has slight tracheal deviation to the right side.
C. The water seal chamber fluctuates while the patient inhales and exhales.
D. The patient complains of tenderness at the chest tube insertion site.
B
Which statement is CORRECT about a tension pneumothorax?*
A. This condition happens when an opening to the intrapleural space creates a two-way valve which causes pressure to build up in the space leading to shifting of the mediastinum.
B. A tension pneumothorax is a medical emergency and is treated with needle decompression.
C. Tracheal deviation is an early sign of a tension pneumothorax
D. An open pneumothorax is the only cause of a tension pneumothorax.
B
A patient receiving treatment for a pneumothorax calls on the call light to tell you something is wrong with their chest tube. When you arrive to the room you note that the drainage system has fallen on its side, and there is a large crack in the system. What is your next PRIORITY?
A. Place the patient in supine position and clamp the tubing.
B. Notify the physician immediately.
C. Disconnect the drainage system and get a new one.
D. Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system.
D
