Respiratory Emergencies: Pneumothorax & Embolism
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Questions and Answers

What effect does pulmonary hypertension have on the pulmonary arterial pressure?

  • It does not affect the pulmonary arterial pressure.
  • It increases the pulmonary arterial pressure. (correct)
  • It decreases the pulmonary arterial pressure.
  • It stabilizes the pulmonary arterial pressure.

    • Which of the following is a primary symptom of pulmonary hypertension?

  • Fever
  • Chest tightness
  • Dyspnea (correct)
  • Coughing with phlegm

    • What happens to the right ventricle as a result of increased pulmonary vascular resistance?

  • It experiences hypertrophy and eventual failure. (correct)
  • It enhances its contractility.
  • It becomes smaller.
  • It becomes rigid and immobile.

    • Which diagnostic procedure can assess elevated pulmonary arterial pressure?

    <p>Cardiac catheterization</p> Signup and view all the answers

    What is a common consequence of pulmonary embolism on pulmonary vascular resistance?

    <p>It increases pulmonary vascular resistance.</p> Signup and view all the answers

    Which ECG change is associated with right ventricular hypertrophy due to pulmonary hypertension?

    <p>Right axis deviation and tall anterior R waves</p> Signup and view all the answers

    Which symptom is NOT typically associated with right-sided heart failure resulting from pulmonary hypertension?

    <p>Increased appetite</p> Signup and view all the answers

    What might a lung biopsy help diagnose in the context of pulmonary hypertension?

    <p>Interstitial lung disease</p> Signup and view all the answers

    What is the primary purpose of inserting a chest tube?

    <p>To remove air and fluid and re-establish negative pressure</p> Signup and view all the answers

    What is a common risk factor for pulmonary embolism related to blood flow?

    <p>Prolonged immobilization</p> Signup and view all the answers

    Which condition is NOT considered a risk factor for developing pulmonary embolism?

    <p>Low blood pressure</p> Signup and view all the answers

    What type of emergency does a massive pulmonary embolism represent?

    <p>A life-threatening emergency</p> Signup and view all the answers

    Which symptom results from the impairment of gas exchange in pulmonary embolism?

    <p>Shortness of breath</p> Signup and view all the answers

    What should nursing management focus on regarding patients at risk for pulmonary embolism?

    <p>Promoting early detection and patient assessment</p> Signup and view all the answers

    Which of the following is a part of the nursing responsibilities during chest tube insertion?

    <p>Maintain chest drainage or water-seal</p> Signup and view all the answers

    Which condition is associated with hypercoagulability that can contribute to pulmonary embolism formation?

    <p>Injury and trauma</p> Signup and view all the answers

    What is the primary characteristic of an open pneumothorax?

    <p>Air passes freely in and out of the thoracic cavity.</p> Signup and view all the answers

    Which of the following is a life-threatening complication of tension pneumothorax?

    <p>Mediastinal shift toward the unaffected side.</p> Signup and view all the answers

    What clinical manifestation is most likely seen in a patient with a significant pneumothorax?

    <p>Acute respiratory distress.</p> Signup and view all the answers

    What is a potential cause of spontaneous pneumothorax?

    <p>Lacerated lung due to an external wound.</p> Signup and view all the answers

    Which statement correctly describes the respiratory status in a patient with a small pneumothorax?

    <p>They may have only minimal respiratory distress and chest discomfort.</p> Signup and view all the answers

    During thoracentesis, what complication can arise if the pleura is inadvertently punctured?

    <p>Tension pneumothorax.</p> Signup and view all the answers

    What does hyperresonance on percussion of the chest suggest in the context of pneumothorax?

    <p>Presence of air in the pleural space.</p> Signup and view all the answers

    Which symptom might indicate severe hypoxemia in a pneumothorax patient?

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

    What is the appropriate action to minimize chest pain during treatment?

    <p>Place the patient in a semi-Fowler’s position and turn frequently</p> Signup and view all the answers

    Which of the following is an essential part of oxygen therapy management?

    <p>Monitor for signs of hypoxemia and assess pulse oximetry values frequently</p> Signup and view all the answers

    What should be encouraged to address a patient's anxiety during treatment?

    <p>Allow patients to express their feelings and provide accurate information</p> Signup and view all the answers

    What complication should a nurse be alert for in a patient with pulmonary embolism?

    <p>Cardiogenic shock or right ventricular failure</p> Signup and view all the answers

    Which of the following should be measured to assess postoperative care effectively?

    <p>Pulmonary arterial pressure and urinary output</p> Signup and view all the answers

    What should patients taking anticoagulants be advised to monitor?

    <p>For signs of bruising and bleeding</p> Signup and view all the answers

    What is a recommended practice for patients recovering from surgery to prevent complications?

    <p>Wear antiembolism stockings as directed</p> Signup and view all the answers

    What is the hallmark diagnostic feature of ARDS?

    <p>Refractory hypoxemia</p> Signup and view all the answers

    What is one critical instruction for patients about to take warfarin sodium?

    <p>Check with a physician before taking any medications</p> Signup and view all the answers

    Which change in arterial blood gases is typical in the early stages of ARDS?

    <p>Hypoxemia with respiratory alkalosis</p> Signup and view all the answers

    What does a chest CT scan commonly reveal in ARDS?

    <p>Bilateral pulmonary infiltrates</p> Signup and view all the answers

    What is a primary focus in managing ARDS?

    <p>Identification of the underlying condition</p> Signup and view all the answers

    Which treatment method is used to improve oxygenation in ARDS patients?

    <p>Delivering high FiO2 levels with high-flow systems</p> Signup and view all the answers

    What does pulmonary artery pressure monitoring typically show in ARDS?

    <p>Normal pressures distinguishing it from cardiogenic pulmonary edema</p> Signup and view all the answers

    What is crucial during the administration of noninvasive CPAP in ARDS patients?

    <p>Monitoring for contraindications is essential</p> Signup and view all the answers

    What complication is NOT typically associated with ARDS management?

    <p>Severe hypertension</p> Signup and view all the answers

    Study Notes

    Pneumothorax

    • May be caused by blunt trauma, penetrating trauma, or diaphragmatic tear
    • Can occur during procedures that puncture the pleura, like thoracentesis or insertion of a subclavian line
    • Can be a complication of barotrauma from mechanical ventilation
    • Open pneumothorax: A wound in the chest wall allows air to pass freely in and out of the thoracic cavity
    • Tension pneumothorax: Air is trapped in the pleural space with each breath, leading to lung collapse and mediastinal shift
    • Clinical Manifestations: Sudden pleuritic pain, minimal to acute respiratory distress, anxiety, dyspnea, air hunger, use of accessory muscles, central cyanosis, and decreased chest expansion

    Pulmonary Embolism

    • Definition: Obstruction of the pulmonary artery or its branches by a thrombus originating in the venous system or right heart
    • Risk Factors: Venous stasis, hypercoagulability, venous endothelial disease, certain disease states, predisposing conditions
    • Clinical Manifestations: Symptoms depend on the size of the thrombus and the location of the occlusion. Dyspnea, pleuritic chest pain, anxiety, cough, hemoptysis, tachycardia, tachypnea, fever, hypotension, syncope.
    • Management: Oxygen therapy, analgesics, anticoagulation, thrombolytics, surgical embolectomy

    Pulmonary Hypertension

    • Occurs when the pulmonary artery pressure increases due to increased workload on the right ventricle
    • Clinical Manifestations: Dyspnea, substernal chest pain, weakness, fatigability, syncope, hemoptysis, right-sided heart failure signs (peripheral edema, ascites, distended neck veins, liver engorgement, crackles, heart murmur)
    • Assessment and Diagnostic Findings: Lung biopsy, cardiac catheterization, echocardiogram

    Acute Respiratory Distress Syndrome (ARDS)

    • Definition: A severe lung injury that causes widespread inflammation and fluid leakage into the alveoli, leading to hypoxemia and respiratory failure.
    • Hallmark: Refractory hypoxemia (hypoxemia that doesn't improve with oxygen administration)
    • Diagnostic Tests: Arterial blood gases, chest X-ray, chest CT scan, pulmonary function testing, pulmonary artery pressure monitoring

    ARDS Management

    • Focus: Identify and treat the underlying condition.
    • Goals:
      • Improve oxygenation
      • Improve ventilation
      • Prevent complications
    • Key Components:
      • Mechanical ventilation
      • Prone positioning
      • Fluid management
      • Nutritional support
      • Medications (antibiotics, corticosteroids, sedation)
    • Critical Care Bundles:
      • Early identification and recognition of ARDS
      • Ventilator bundle (low tidal volume, permissive hypercapnia)
      • Sedation and analgesia bundle
      • Fluid management bundle
      • Nutritional support bundle
      • Prevention of complications bundle

    Nursing Management

    • General:
      • Assess respiratory status and vital signs
      • Provide supplemental oxygen
      • Monitor chest tube drainage (if applicable)
      • Provide emotional support
      • Educate patients and families
    • Specific Nursing Interventions:
      • Monitor patient's response to therapy
      • Maintain airway patency
      • Promote lung expansion
      • Prevent respiratory infections
      • Manage pain and anxiety
      • Monitor for complications
      • Collaborate with other healthcare professionals
      • Educate patients and families about the condition, treatment, and prevention strategies
    • Home and Community-Based Care:
      • Teach patients about their illness and how to manage their condition at home.
      • Encourage healthy lifestyle changes, including smoking cessation, weight loss, and exercise.
      • Advise patients on potential complications and signs/symptoms for seeking medical attention.
      • Provide emotional support and resources.

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    Description

    This quiz covers critical aspects of pneumothorax and pulmonary embolism, including their causes, clinical manifestations, and risk factors. Test your knowledge on the different types of pneumothorax and the implications of pulmonary embolism on patient health. Get ready to delve into essential respiratory emergency concepts.

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