Spontaneous Pneumothorax Flashcards
A patient present with acute onset of unilateral chest pain, shortness of breath, and unilateral chest expansion. Auscultation reveals hyperresonance and diminished breath sounds on the left side. What do you suspect is the cause? A: Left-sided pneumonia B: Empyema C: Left-sided Pleural Effusion D: Left-sided Pneumothorax
D: Left-sided Pneumothorax
What is an emergency complication that can occur from a spontaneous pneumothorax? A: lung abscess B: empyema C: tension pneumothorax D: shock
C: tension pneumothorax
Answer: C (mediastinal shift, cyanosis, hypotension – signs of tension pneumothorax – EMERGENCY! REFER!)
What would be a key finding in a small pneumothorax? A: hypotension B: tachycardia C: hypoxemia D: EKG changes
B: tachycardia
What diagnostic study should the FNP order when suspecting a pneumothorax?
Answer: Chest X-ray (adequate, inexpensive, and rapid results)
The FNP ordered a chest x-ray to diagnose a pneumothorax. The chest x-ray would demonstrate what findings to confirm this diagnosis?
Answer: demonstrating the outer margin of the visceral pleura (and lung) – known as the pleural line – separated from the parietal pleura (and chest wall) by a lucent gas space devoid of pulmonary vessels.
If a pneumothorax is considered small and stable, what treatment should the FNP provide?
Answer: Symptomatic treatment (treat cough, pain; and consider serial CXR every 24hr – however, observation alone may be appropriate (many spontaneously resolve as air is absorbed from pleural space; provide O2 to increase rate of absorption)
The FNP has determined the pneumothorax is large and progressive. What intervention should the FNP employ?
Answer: REFER! Needle decompression is needed to prevent tension pneumothorax
The FNP knows common risk factors for recurrence of spontaneous pneumothorax include (SELECT ALL THAT APPLY): A: Smoking B: Swimming C: Alcohol Use D: Flying on an airplane
A: Smoking
D: Flying on an airplane
Answer: A, D
