Pneumothorax and Related Conditions Flashcards

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Questions and Answers

Which of the following is NOT a correct statement about this type of pneumothorax?

Smoking increases the chances of a patient developing a spontaneous pneumothorax.
It can occur in patients who are young, tall and thin without a history of lung disease.
It is most likely to occur in patients with COPD, asthma, and cystic fibrosis. (correct)
It can be caused by the rupture of a pulmonary bleb.

When charting findings for a patient with 'bulging' areas of skin on the neck, face, and abdomen that feel 'crunchy', what term would be used?

Veisalgia
Pigment molle
Subcutaneous emphysema (correct)
Subcutaneous paresthesia

If a patient with a pneumothorax has a chest tube with no fluctuation of water in the water seal chamber, what should your next action be?

Keep monitoring the patient because this is a normal finding.
Assess patient's lung sounds to assess if the affected lung has re-expanded. (correct)
Notify the physician.
Increase wall suction to the system until the water fluctuates in the water seal chamber.

Select ALL the signs and symptoms that can present with tension pneumothorax.

Jugular Venous Distention (B), Tracheal deviation (C), Tachypnea (D), Hypotension (E) Signup and view all the answers

Which finding during the assessment of a patient with a chest tube for pneumothorax requires immediate nursing intervention?

The patient has slight tracheal deviation to the right side. (B) Signup and view all the answers

Which statement is CORRECT about a tension pneumothorax?

A tension pneumothorax is a medical emergency and is treated with needle decompression. (A), Tracheal deviation is an early sign of a tension pneumothorax. (C), This condition happens when an opening to the intrapleural space creates a two-way valve which causes pressure to build up in the space leading to shifting of the mediastinum. (D) Signup and view all the answers

What is your next PRIORITY if a drainage system for a pneumothorax has fallen on its side with a large crack in it?

Disconnect the tubing from the drainage system and insert the tubing 1 inch into a bottle of sterile water and obtain a new system. (A) Signup and view all the answers

What is pneumothorax?

Air leaking into the space between the lung and chest wall (C) Signup and view all the answers

What is closed pneumothorax?

Caused by air leaking into the pleural space from an opening within the lung. Signup and view all the answers

What defines open pneumothorax?

An open wound to the chest that allows air to enter the pleural space and cause lung collapse. Signup and view all the answers

What is hemothorax?

The accumulation of blood between the membranes lining the lungs (the pleura). Signup and view all the answers

The rib fractures are most commonly fractured because they are the least protected by chest muscles. Rib fractures are most commonly fractured are ribs ___

5-9 Signup and view all the answers

What are the risk factors for hemothorax and pneumothorax?

All of the above (D) Signup and view all the answers

What is flail chest?

A condition in which two or more ribs are fractured in two or more places, causing segmental movement of the chest wall. Signup and view all the answers

Match the following with their definitions:

Atelectasis = Collapsed lung Cardiac Tamponade = Acute compression of the heart due to fluid accumulation Thoracostomy = Creation of an opening in the chest to insert a tube Chylothorax = Presence of lymphatic fluid in the pleural space Signup and view all the answers

A chest tube will be placed __ in the lung with the presence of a pneumothorax (approximately 2nd intercostal space).

higher Signup and view all the answers

A chest tube will be placed __ in the lung with the presence of a hemothorax (approximately 5th intercostal space).

lower Signup and view all the answers

What are the signs and symptoms of cardiac tamponade?

Anxiety and restlessness, low blood pressure, weakness, chest pain radiating to neck, shoulders, or back, trouble breathing, rapid breathing, discomfort relieved by leaning forward. Signup and view all the answers

What is Beck's triad of cardiac tamponade?

Hypotension, muffled heart sounds, elevated neck veins (C) Signup and view all the answers

Which of the following is considered an indication for open thoracotomy?

Initial output of hemothorax drainage greater than 1500 mL (B) Signup and view all the answers

What is tension pneumothorax?

Air enters pleural space but cannot escape. (A) Signup and view all the answers

What is the primary treatment for tension pneumothorax?

Needle decompression followed by chest tube insertion. Signup and view all the answers

What are common signs and symptoms of tension pneumothorax?

Dyspnea, marked tachycardia, tracheal deviation, decreased breath sounds, neck vein distention, cyanosis. Signup and view all the answers

Which of the following is a LATE sign of the development of a tension pneumothorax?

Tracheal deviation (D) Signup and view all the answers

What is the treatment for hemothorax?

Chest tube with water seal drainage, autotransfusion of collected blood, treatment of hypovolemia as necessary. Signup and view all the answers

What medications can be used for chest trauma?

Benzodiazepines (lorazepam), opioid agonists. Signup and view all the answers

What is rib fracture management?

No strapping or binding chest; NSAIDs, opioids, deep breathing exercises. Signup and view all the answers

What is the definition of chylothorax?

Presence of lymphatic fluid in the pleural space. Signup and view all the answers

MVA are responsible for 80% of blunt chest traumas.

True (A) Signup and view all the answers

Negative pressure exists between visceral and parietal pleura to assist lung expansion.

True (A) Signup and view all the answers

What is the significance of rapid, shallow respirations in the context of chest trauma?

It indicates respiratory distress and the need for immediate assessment. Signup and view all the answers

Study Notes

Pneumothorax

Occurs when air leaks into the pleural space, leading to lung collapse.
Closed pneumothorax: Air enters pleural space through a lung opening.
Open pneumothorax: Air enters pleural space via an open chest wound.

Hemothorax

Blood accumulates in the pleural space.
Common risk factors include blunt and penetrating trauma, occluded chest tubes, and COPD.

Flail Chest

Characterized by multiple rib fractures, causing a segment of the chest wall to detach.
Leads to paradoxical chest movement, crepitus, and asymmetric expansion.

Cardiac Tamponade

Acute heart compression due to fluid in the pericardial cavity.
Causes decreased cardiac filling and output, leading to pulmonary and venous congestion.
Beck's triad: Hypotension, muffled heart sounds, elevated neck veins.

Diagnostic Procedures

CT scan: Gold standard for diagnosing pneumothorax.
Chest tube placement: For pneumothorax (2nd intercostal space) and hemothorax (5th intercostal space).

Treatment Modalities

Pneumothorax: Can heal on its own; options include thoracentesis, chest tube insertion, and pleurodesis.
Hemothorax: Treated with chest tube drainage, possible autotransfusion, and supportive measures.
Cardiac tamponade: Managed through pericardiocentesis and possibly surgical repair.

Signs and Symptoms

Pneumothorax: Symptoms vary; include dyspnea, chest pain, absent breath sounds, and hypoxemia.
Hemothorax: Present with dyspnea, dullness to percussion, decreased hemoglobin, and shock.
Cardiac Tamponade: Presents with muffled heart sounds, tachycardia, hypotension, and neck vein distention.
Flail Chest: Rapid, shallow breaths, crepitus, and splinting behavior.

Types of Trauma

Blunt Trauma: Can cause significant internal injuries without visible external damage.
Penetrating Trauma: Involves open wounds from objects like knives or bullets, leading to significant internal compromise.

Complications

Tension pneumothorax: Air enters the pleural space and cannot escape, leading to increased pressure, lung collapse, and mediastinal shift.
Symptoms include severe dyspnea, tachycardia, tracheal deviation, and hypotension.

Interventions

Immediate interventions for tension pneumothorax include needle decompression and chest tube insertion.
For chest trauma, focus on airway management, supplemental oxygen, and IV access for fluid resuscitation.

Nursing Considerations

Monitor vital signs, consciousness, oxygen saturation, and cardiac rhythm.
Educate patients on signs of complications and the importance of follow-up.
Avoid strapping or binding the chest due to the risk of atelectasis.

Risk Factors & Prevention

Bleb formation: Associated with spontaneous pneumothorax risk, particularly in tall, thin, young males, and smokers.
Iatrogenic pneumothorax: Can occur from medical interventions like central line placement or thoracentesis.

Medications & Management

Use benzodiazepines and opioid agonists for pain management in chest trauma.
Encourage deep breathing and coughing to prevent complications like atelectasis and pneumonia following rib fractures.### Tension Pneumothorax
Tracheal deviation to the right indicates possible tension pneumothorax.
Pressure builds in the intrapleural space due to a one-way valve effect from an opening, shifting the mediastinum.
Considered a medical emergency requiring immediate treatment, typically needle decompression.
Early sign includes tracheal deviation.

Chest Tube Complications

Fluctuation in the water seal chamber is normal with patient respiration.
Tenderness at the chest tube insertion site should be monitored and evaluated.
If a chest drainage system is compromised (e.g., cracked or fallen), prioritize patient safety.
Correct response involves inserting disconnected tubing into sterile water and acquiring a new drainage system.

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Description

This quiz focuses on flashcards covering various conditions related to pneumothorax, hemothorax, tension pneumothorax, and flail chest. Ideal for medical students or healthcare professionals looking to reinforce their knowledge on respiratory emergencies.