Unit 4 Chapter 29 Pneumothorax, Tension Pneumothorax, Hemothorax,

Question 1

What is Pneumothorax

Answer 1

pneumothorax Air in the pleural space causing a loss of negative pressure in the chest cavity, a rise in chest pressure, and a reduction in vital capacity, which can lead to lung collapse.

Question 2

What are the types of Pneumothorax?

Answer 2

Open: (Air escaping lung through open penetration of pleural space)
*Cause by Gunshot, knife
Nursing intervention; Wound needs to be covered because more air will continue to move in with each breathe.

Closed(- air enters the pleural space with inhalation but has not exit point)
*Tension Pneumothorax: Caused by (PEEP) Positive End Expiratory Pressure.
Nursing Intervention: Chest Tube

Sponatenous Pneumothorax
(No obvious reasons)
*Issues with lungs from illnesses or
from injury due to smoking
*Can occur due to changes in air
pressure – scuba diving, flying,
mountain climbing

Question 3

Clinical Manifestations of Pneumothorax

Answer 3

Clinical manifestations
Reduced breath sounds
* Affected side moves poorly with respiration
* Tracheal deviation
* Tachypnea
Pleuritic pain
Hyperressance to percussion at the base of the lung
Subcutaneous emphysema

Question 4

Is Tension Pneumothorax a medical emergency?
A. No
B. Yes

Answer 4

A tension pneumothorax is a life-threatening complication of pneumothorax in which air continues to enter the pleural space during inspiration and does not exit during expiration

Question 5

Which of the following patients should the nurse assess first
A. The client with chronic asthma and is experiencing wheezing
B. The client is becoming unconscious and has left absent lung sounds.
C. The patient with cystic fibrosis is coughing up thick secretions.
D. The patient with Hepatic Encapaltholpy that exhibits asterixis

Answer 5

B. The client is becoming unconscious and has left absent lung sounds.

WHEEZING IS BETTER THAN ABSENT LUNG SOUNDS

Question 6

Which patient would you tell the shift change nurse to assess first?
A. The patient who has been receiving 6L/m SaO2 on nasal cannula and their O2 sat has not increased in 3 minutes.
B. The patient with cirrhosis who is complaining about the itchiness of their skin
C. The patient who is placed on a dysphagia diet is placed in a side-lying position.
D. The patient is on a mechanical ventilator and is sedated with a SaO2 of 100%.

Answer 6

A. The patient who has been receiving 6L/m SaO2 on nasal cannula and their O2 sat has not increased in 3 minutes.

Question 7

Clinical Manifestations of Tension Pneumothorax

Answer 7

• Tracheal Deviation
• Extreme respiratory distress
• Cyanosis
• Distended neck veins (JVD)
• Hemodynamic instability
  Asymmetrical Chest
• Absence of breath sounds on one side

Question 8

What is Hemothorax

Answer 8

It is often caused by blunt chest trauma and may occur with some degree of hemothorax, which is bleeding into the chest cavity. It can also occur as a complication of medical procedures. (A simple hemothorax is a blood loss of less than 1000 mL into the chest cavity; a massive hemothorax is a blood loss of more than 1000 mL.)

Question 9

What is the treatment for both Hemothorax and Tension Pneuthorax?

Answer 9

CHEST TUBE
^CHAPTER 27

Interventions for hemothorax include chest tube placement to remove the blood in the pleural space to normalize breathing and prevent infection.