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NSG 430 - Critical Care > T3: Chest Trauma > Flashcards

T3: Chest Trauma Flashcards

1
Q

blunt trauma

A

*occurs when the chest strikes or is struck by an object

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2
Q

Penetrating trauma

A

is an injury in which a foreign object impales or passes through the body tissues, creating an open wound

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3
Q

treatment options for chest trauma

A

depends on severity; may resolve spontaneously
*Thoracentesis
*Chest tubes
*Pleurodesis

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4
Q

thoracentesis

A

surgical puncture to remove fluid from the pleural space

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5
Q

Pleurodesis

A

creation of adhesions between the parietal and visceral pleura to treat recurrent pneumothorax

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6
Q

most common rib fracture

A

5-9

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7
Q

clinical manifestations of rib fractures

A

*Pain
*Splinting
*Shallow respirations

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8
Q

What can rib fractures lead to?

A

atelectasis and pneumonia

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9
Q

treatment for rib fracture

A

*NO strapping or binding chest
*NSAIDs, opioids, nerve blocks

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10
Q

patient teaching for rib fracture

A

*Deep breathing and coughing
*Incentive spirometry
*Appropriate use of anaglesics

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11
Q

flail chest

A

fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment

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12
Q

clinica manifestations of flail chest

A

-movement of thorax is asymetric and uncoordinated (moves air poorly)
-rapid shallow breaths
-tachycardia
-chest splinting

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13
Q

diagnosis of flail chest

A

-Observation of abnormal thoracic cavity movements
-palpitation for crepitus near the rib fractures
-chest x-ray

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14
Q

management of flail chest

A

*Adequate airway and ventilation
*Oxygen therapy
*Analgesia
*Surgical fixation

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15
Q

signs of respiratory distress

A

*Dyspnea
*Cough with or without hemoptysis
*Cyanosis
*Tracheal deviation
*Decreased breath sounds
*Decreased O2 saturation
*Frothy secretions

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16
Q

signs of cardiovascular compromise

A

*Rapid, thready pulse
*Decreased BP with narrowed pulse pressure and/or asymmetric readings
*Distended neck veins
*Muffled heart sounds
*Chest pain
*Dysrhythmias

17
Q

Initial interventions for any patient with chest trauma include

A

*Circulation, airway, breathing
*Administer O2
*Establish IV access with 2 large-bore catheters and begin fluid resuscitation as appropriate
*Remove clothing to assess injury
*Cover sucking chest wound with nonporous dressing taped on 3 sides
*Stabilize impaled objects
*Place patient in a semi-Fowler’s position or on injured side
*After ruling out cervical spine injury
*Administer analgesia
*Prepare for emergency needle decompression

18
Q

sucking chest wound care

A

(an open chest wound)
*Cover with nonporous dressing taped on 3 sides

19
Q

when there is a chest wound with an impaled object

A

*Stabilize impaled objects with bulky dressings. Do not remove object.

20
Q

Chest Tubes and Pleural Drainage

A

-To remove air or fluid from pleural and/or mediastinal space
-Reestablishes negative pressure
-Lung reexpands

21
Q

Flutter (Heimlich) Valve

A

-One-way valve that is used to evacuate air from the pleural space, attached to a drainage bag that has a vent opening

22
Q

Bubbling in water-seal chamber indicates

A

air leak

23
Q

Tidaling in water chamber of chest tube reflects

A

*changes in pressure, this will disappear as lung reexpands

24
Q

treatments for lung cancer

A

chemo, radiation, or surgery

25
Q

SE of chemo

A

-NV; anorexia
-mucosal irritation
-alopecia
-mood changes/depression

26
Q

nadir

A

WBC count LOW after chemo and makes the patient at increased risk for oppportunistic infection (usually 10-14 days after chemo)

27
Q

Chemo precautions

A

isolation for patient, no fresh flower, fruit or veggies

28
Q

clinical manifestations of lung cancer

A

*Anorexia, fatigue, weight loss
*Nausea/vomiting
*Hoarseness
*Unilateral paralysis of diaphragm
*Dysphagia
*Palpable lymph nodes

29
Q

PET scan

A

scans for metastasis by giving glucose, tumors love glucose so they will soak it up and the scan will light up where there is a tumor

30
Q

thoracotomy

A

incision of the chest

31
Q

lobectomy

A

removal of a lobe

32
Q

Pneumonectomy

A

removal of a lung

33
Q

post op concerns of thoracotomy

A

*Pain
*Chest tubes
*Respiratory distress and effort
*Daily CXRs for lung re-xpansion
*Pneumonectomies—area fills with fluid

34
Q

if a lung transplant is done, what does the patient need to do

A

-take antirejection medications (on the minute and hour, lifelong)
-vaccinations (not live ones)

35
Q

3 meds specific to suppress immune system:

A

-Mycophenolate Cellcept
-Tacrolimus
-Prednisone

36
Q

Rejection signs and symptoms:

A

Fever, chills, fatigue, dyspnea, cough, low O2 sats

NSG 430 - Critical Care (42 decks)

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