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ACVN - SURGICAL NURSING > Thoracic Surgical Conditions > Flashcards

Thoracic Surgical Conditions Flashcards

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1
Q

what are the clinical signs associated with lower thoracic conditions?

A
  • Tachypnoea
  • Abnormal breathing
  • Orthopnoea
  • Hyperpnoea
  • Dyspnoea
  • Abdominal breathing
  • +/- Cough
  • Pale mucous membranes > cyanosis
  • Exercise intolerance > collapse
  • +/- injuries
  • +/- systemically ill
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2
Q

what preliminary management would you do if a patient has a lower thoracic condition?

A
  • Minimise deterioration
  • Oxygen
  • Wounds
  • Monitor the patient closely
  • Temperament
  • Progression
  • Diagnostics
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3
Q

how can you provide oxygen?

A
  • Flow by
  • Nasal cannula
  • Face mask
  • Oxygen collar
  • Oxygen cage
  • Intubation
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4
Q

what diagnostic imaging can be done?

A

radiography and ultrasound?

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5
Q

what can radiologiy and ultrasound diagnose?

A
  • Pleural effusion
  • Pneumothorax
  • Foreign bodies
  • Soft tissue masses e.g., abscess / neoplasia
  • Traumatic injuries e.g., broken ribs; diaphragmatic rupture
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6
Q

what would radiography or ultrasound determine if pleural effusion is diagnosed?

A
  • Unilateral / bilateral
  • Small volume / large volume
  • Thoracocentesis required
  • Lab analysis
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7
Q

whatwould ultrasoundor radiography determine if pneumothroax was diagnosed?

A
  • Open / closed chest important
  • Unilateral / bilateral
  • Small volume / large volume
  • thoracocentesis required
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8
Q

how would you spot a foreign body on ultrasound or radiography?

A

the foreign body will be radiopaque or radiolucent

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9
Q

what surgical thoracic conditions are?

A
  • Pneumothorax
  • Chest and lung trauma
  • Pulmonary blebs or bullae
  • Diaphragmatic rupture
  • Pleural effusion
  • Pyothorax
  • Pericardial effusion
  • Pulmonary neoplasia
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10
Q

what is a pyothorax?

A

pus in the chest

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11
Q

what is a pericardialeffusion?

A

fluid around the heart

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12
Q

what is pulmonary neoplasia?

A

lung cancers

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13
Q

what type of pneumothorax is it if there is an internal air leak?

A

internal air leak

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14
Q

what type of pneumothorax is it if there is an external air leak?

A

closed

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15
Q

what accidental trauma might cause chest and lung trauma?

A

RTA, train, fall/jump off a cliff, impaling or run on injury

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16
Q

what are the clinical signs of chest and lung trauma?

A
  • Shock likely to be a big component
  • Dyspnoea
  • Soft tissue damage - Open, can be very extensive - Bruising / crushing, these wounds progress
  • Ortho damage
  • Rib fractures including flail chest
  • Other parts of the skeleton can complicate management
17
Q

what are complications that can arise from chest and lung trauma surgery?

A
  • Infection /Inflammation
  • Issues with healing
  • Ongoing effusion/Pneumothorax
18
Q

where are blebs found?

A

on the edges of lung lobes

19
Q

where are bullae found?

A

within the lung lobes

20
Q

what are the non-specific clinical signs of pulmonary blebs/bullae?

A

lethargy, anorexia, exercise intolerance

21
Q

what are the respiraotyr signs of pulmonary blebs and bullae?

A

sudden onset dyspnoea, progressive tachypnoea/orthopnoea/coughing
spontanous closed tension pneumothorax

22
Q

what are the clinical signs of diaphragmatic rupture?

A
  • None / Vague ill-health
  • Dyspnoea / Shock
  • Severity
  • Speed of onset
  • Herniation
  • Concurrent injuries
23
Q

how would you stabilise a patient with diaphragmatic hernia?

A

oxygen, anlagesia, IVFT

24
Q

what are the clinical signs of pleural effusion?

A
  • Dyspnoea
  • Lethargy
  • Cough
  • Exercise intolerance
25
Q

how would you diagnose a pleural effusion?

A
  • Imaging
  • Thoracocentesis
  • Lab work
26
Q

what is the causes of a cat with pyothorax?

A

idiopathic e.g bites, extension from pulmonary abscesses
pasteurella

27
Q

what are the causes of pyothorax in dogs?

A

foreign bodies, oesophgeal tears, pulmonary infection

28
Q

what arethe clinincal sign sof pyothorax?

A

lethargy, inappetance, pyrexia of unknown origin

29
Q

how can you treat a pyothorax?

A

conservative management (antibiotics)
surgery (sternotomy)

30
Q

what are the clinical signs of pericardial effusion?

A

cardiac tamponade, collapse

31
Q

how would you treat pericardial effusion?

A

pericardiocentesis, pericardectomy

32
Q

what are the clinical signs of pulmonary neoplasia?

A

vague, lameness, non-productive cough, haemoptysis, dyspnoea, non-specific weight loss, exercise intolerance, anorexia

33
Q

what treatment can be provided to pulmonary neoplasia patients?

A

palliative, thoractomy for lung lobectomy

34
Q

how would you nurse a thoractomy patinet?

A
  • nalgesia
  • Management of hypothermia
  • Preparation for IPPV once thorax is open
  • Monitoring
  • TPR
  • Pain scoring
  • Drugs
  • Appropriate drug regime
  • Surgical site & Wound management if trauma case
  • May include ointments/ gels to reduce air leaks
  • body bandage for comfort, reduced infection risk and patient interference
35
Q

how would you nurse a hospitalised thoracotomy patient?

A
  • Assistance with basic functions like eating, drinking, urinating, defaecating
  • IVFT to take into account fluid losses
  • Urinary catheters if struggling to do it themselves e.g. cat can’t get into litter tray; dog struggling to
    walk outside
  • DON’T NEED MORE ANALGESIA IF WHAT THEY NEED IS TO URINATE!
  • Feeding tubes to take into account calorifics needs and increased losses while healing

ACVN - SURGICAL NURSING (17 decks)

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