Pneumothorax and Hemothorax
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Questions and Answers

What occurs during a tension pneumothorax?

  • Blood accumulates in the pleural space.
  • Lung elasticity is unaffected.
  • Air can exit the pleural space during expiration.
  • Air enters the pleural space and cannot exit, increasing pressure. (correct)

    • Which condition is characterized by multiple rib fractures leading to paradoxical chest wall movement?

  • Pneumothorax
  • Tension pneumothorax
  • Flail chest (correct)
  • Hemothorax

    • What is the main consequence of a mediastinal shift caused by a tension pneumothorax?

  • Reduced pressure in the pleural space
  • Decreased venous return (correct)
  • Enhanced cardiac output
  • Increased lung expansion

    • Which of the following is a risk factor for developing a pneumothorax?

    <p>Older age with decreased lung elasticity</p> Signup and view all the answers

    What typically triggers a spontaneous pneumothorax?

    <p>Rupture of a small bleb on the lung</p> Signup and view all the answers

    What is a common physical assessment finding in a patient experiencing respiratory distress?

    <p>Cyanosis</p> Signup and view all the answers

    In a patient with a tension pneumothorax, what would you expect to find upon percussion of the chest?

    <p>Hyperresonance</p> Signup and view all the answers

    Which laboratory finding is indicative of hypoxemia in a patient?

    <p>PaO2 less than 80 mm Hg</p> Signup and view all the answers

    What is a significant assessment finding that suggests the presence of subcutaneous emphysema?

    <p>Air accumulation in subcutaneous tissue</p> Signup and view all the answers

    Which of the following is not a manifestation of respiratory distress?

    <p>Hypotension</p> Signup and view all the answers

    What is the primary purpose of performing a chest x-ray in cases of suspected pneumothorax or hemothorax?

    <p>To confirm the presence of air or fluid in the pleural space</p> Signup and view all the answers

    Which nursing action is NOT a responsibility during a thoracentesis procedure?

    <p>Administering sedative medications</p> Signup and view all the answers

    What should a patient be instructed to do during the thoracentesis procedure?

    <p>Remain still without moving, coughing, or deep breathing</p> Signup and view all the answers

    What sensation might a patient experience when the needle is inserted into the pleural space during thoracentesis?

    <p>Sensation of pressure</p> Signup and view all the answers

    What is the role of the nurse in assisting with the client's positioning for thoracentesis?

    <p>Assisting the patient to lean over a bedside table</p> Signup and view all the answers

    What is a recommended nursing action to enhance a patient's ventilation?

    <p>Position the client to maximize ventilation in high-Fowler’s position.</p> Signup and view all the answers

    Which of the following assessments should be performed every 4 hours?

    <p>Monitor vital signs.</p> Signup and view all the answers

    What is the primary purpose of administering emotional support to a client?

    <p>To address psychological well-being during treatment.</p> Signup and view all the answers

    What should be done if there is evidence of infection in a patient?

    <p>Encourage prompt medical attention.</p> Signup and view all the answers

    Which intervention is appropriate for a patient receiving mechanical ventilation?

    <p>Document ventilator settings every 4 hours.</p> Signup and view all the answers

    What are the primary receptors activated by opioid agonists like morphine sulfate and fentanyl?

    <p>Mu and kappa receptors</p> Signup and view all the answers

    Which assessment indicates a need to stop opioid medication immediately?

    <p>Respiratory rate of 12/min or less</p> Signup and view all the answers

    What is the recommended action for a client receiving a fentanyl patch?

    <p>Monitor for pain relief after several hours</p> Signup and view all the answers

    What is a significant nursing action to monitor when a client is on opioid medications?

    <p>Monitor for symptoms of fluid retention</p> Signup and view all the answers

    Which statement regarding patient-controlled analgesia (PCA) is true for the client?

    <p>The safety lockout mechanism prevents overdose</p> Signup and view all the answers

    Which nursing action is essential when monitoring a client receiving benzodiazepines?

    <p>Monitor respiratory status and vital signs.</p> Signup and view all the answers

    What should be included in client education regarding the effects of benzodiazepines?

    <p>Drowsiness and amnesic effects may occur.</p> Signup and view all the answers

    Which interprofessional service is appropriate for a client requiring airway management following sedative administration?

    <p>Respiratory services.</p> Signup and view all the answers

    What is the primary purpose of inserting a chest tube?

    <p>To drain fluid, blood, or air from the pleural space.</p> Signup and view all the answers

    What is a nursing responsibility during chest tube management?

    <p>Continuously monitor vital signs and drainage system function.</p> Signup and view all the answers

    What is an essential practice to prevent infection for clients recovering from respiratory conditions?

    <p>Use proper hand hygiene to prevent infection</p> Signup and view all the answers

    Which action should be recommended to aid lung expansion in a client?

    <p>Deep breathe to promote lung expansion</p> Signup and view all the answers

    What type of immunizations should clients obtain to prevent respiratory complications?

    <p>Immunizations for influenza and pneumonia</p> Signup and view all the answers

    What should clients report to their healthcare provider during recovery from pneumothorax or hemothorax?

    <p>Sharp chest pain and difficulty breathing</p> Signup and view all the answers

    What aspect of recovery involves psychological support for patients?

    <p>Talking with family or support people to express feelings about the condition</p> Signup and view all the answers

    Which nursing action is essential during chest tube management?

    <p>Monitoring chest tube placement and drainage function</p> Signup and view all the answers

    What client education should be provided to promote lung expansion during recovery?

    <p>Engage in deep breathing and use of incentive spirometry</p> Signup and view all the answers

    Which of the following symptoms should a client report to their provider during recovery?

    <p>Progressive difficulty breathing or sharp chest pain</p> Signup and view all the answers

    Which of the following is NOT a recommended nursing action after chest tube insertion?

    <p>Immediately remove the chest tube when drainage stops</p> Signup and view all the answers

    What is a primary nursing action when a patient experiences decreased cardiac output due to increased intrathoracic pressure?

    <p>Administer IV fluids and blood products as prescribed</p> Signup and view all the answers

    Which nursing action is appropriate to take in response to respiratory failure caused by lung collapse?

    <p>Prepare for mechanical ventilation</p> Signup and view all the answers

    What vital sign should be closely monitored to assess the effects of decreased cardiac output?

    <p>Blood pressure</p> Signup and view all the answers

    When monitoring intake and output for a patient with respiratory complications, which specific output is significant?

    <p>Chest tube drainage</p> Signup and view all the answers

    What is an expected consequence of inadequate gas exchange due to lung collapse?

    <p>Hypoxemia</p> Signup and view all the answers

    What is an expected finding in a patient with flail chest?

    <p>Cyanosis of the lips and fingertips</p> Signup and view all the answers

    Which nursing intervention is essential for promoting lung expansion in a patient with flail chest?

    <p>Encouraging deep breathing exercises</p> Signup and view all the answers

    What is a common physiological response observed in a patient with flail chest?

    <p>Tachycardia and hypotension</p> Signup and view all the answers

    Which of the following findings indicates paradoxical movement of the chest wall?

    <p>The affected rib segment moves inward during inhalation</p> Signup and view all the answers

    In the management of a patient with flail chest, which action is important when administering pain medication?

    <p>Using patient-controlled analgesia or an epidural block</p> Signup and view all the answers

    Study Notes

    Pneumothorax

    • Pneumothorax: Presence of air/gas in pleural space, causing lung collapse.
    • Tension pneumothorax: Air enters pleural space during inspiration (one-way valve), cannot exit on expiration. Trapped air puts pressure on heart and lung. This increases pressure, compresses blood vessels, limits venous return, decreases cardiac output, and can lead to death if not treated immediately. Increased pressure and air in pleural cavity causes mediastinal shift.

    Hemothorax

    • Hemothorax: Accumulation of blood in pleural space.

    Spontaneous Pneumothorax

    • Spontaneous pneumothorax: Occurs without trauma. A small bleb on the lung ruptures, releasing air into pleural space.

    Flail Chest

    • Flail chest: At least two adjacent ribs (usually one side) sustain multiple fractures, causing chest wall instability and paradoxical chest wall movement. This significantly limits chest wall expansion.

    Assessment and Risk Factors

    • Risk factors: Blunt chest trauma, penetrating chest wounds, closed/occluded chest tube.
    • Older adults: Reduced pulmonary reserves, decreased lung elasticity, and thickened alveoli.
    • Chronic obstructive pulmonary disease (COPD): Increased risk.

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    Description

    This quiz covers the definitions, causes, and effects of pneumothorax, tension pneumothorax, hemothorax, and flail chest. It also discusses assessment and key risk factors associated with these conditions, providing a comprehensive overview of thoracic injuries.

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