Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Respiratory
Chest trauma, chest tube, PE, pneumothorax, thoracentesis
| Question | Answer |
|---|---|
| blunt chest trauma | shearing and compression injuries of thoracic structures rib and sternal fractures can lacerate lung tissue |
| penetrating chest trauma | open wound through pleural space |
| pneumothorax | caused by air entering the pleural space |
| as volume of air in pleural space increases | lung volume decreases |
| clinical manifestations of a small pneumothorax | mild tachycardia, dyspnea |
| clinical manifestations of a large pneumothorax | severe respiratory distress, rapid respirations, air hunger, oxygen desaturation, absent breath sounds over the affected area |
| spontaneous pneumothorax | rupture of blebs (air-filled sacs) |
| risk factors for a spontaneous pneumothorax | smoking, tall and skinny males, family history |
| iatrogenic pneumothorax | caused by a medical procedure - thoracic needle aspiration, bronchial biopsy, esophageal procedures |
| open pneumothorax | air enters through opening in the chest wall penetrating trauma (gunshot wound, stab or thoracotomy) |
| closed pneumothorax | no external wound |
| tension pneumothorax | medical emergency, both respiratory and cardiac systems are affected |
| tension pneumothorax s/s | dyspnea, tracheal deviation, marked tachycardia, decreased or absent breath sounds on affected side, cyanosis, diaphoresis |
| treatment of tension pneumothorax | needle decompression and chest tube |
| hemothorax and treatment | blood in pleural space, chest tube |
| chylothorax | lymphatic fluid in pleural space (milky white) |
| treatment of chylothorax | treat with medications, surgery or pleurodeisis |
| thoracentesis | aspiration of intrapleural fluid, only 1000-1200 mL should be removed |
| procedure for thoracentesis | sit patient on the side of the bed and lean over, monitor VS, O2 saturation and for respiratory distress |
| rib fracture clinical manifestations | pain, splinting, shallow respirations |
| potential complications of rib fractures | atelectasis, and pneumonia |
| treatment of rib fractures | no strapping or binding of chest, NSAIDs, opioids and thoracic nerve blocks |
| patient teaching for rib fractures | deep breathing, incentive spirometry, appropriate use of analgesics |
| flail chest | results from fracture of several consecutive ribs in more than 2 places causing an unstable segment |
| clinical manifestations of flail chest | flail area moves opposite of unaffected side, tachycardia, thorax is assymetrical, rapid and shallow respirations |
| management of flail chest | adequate airway and ventilation, oxygen therapy, analgesia, surgical fixation |
| cardiac tamponade | secondary to collection of blood in pericardial sac, prevents filling of ventricles results in emergent pericardiocentesis |
| clinical manifestations of cardiac tamponade | muffled, distant heart sounds, hypotension, neck vein distention, and increased CVP |
| insertion of chest tube | arm raised on affected side, placed in mid-axillary area --> raise bed 30-60 degrees to lower diaphragm, chest x-ray to confirm, cover with petroleum dressing to prevent air loss |
| nursing management of chest tubes | prepare drainage unit by adding water to water-seal chamber and suction control chamber as indicated, keep tubing loosely coiled, tape all connections, observe for tidaling, observe for air leak (bubbling), observe fluid levels |
| assessment of patient with chest tube | VS, lung sounds, pain, drainage amount, drainage site infection and subcutaneous emphysema, encourage deep breathing, ROM exercises and incentive spirometry |
| complications of chest tube | re-expansion pulmonary edema, vasovagal response, subcutaneous emphysema (crackling sensation is felt) |
| notify health care provider if .... | drainage is > 100 mL per hour, subcutaneous emphysema or respiratory distress occurs |
| if chest tube is accidentally removed.... | place occlusive dressing and secure with tape on three sides, place end in sterile water |
| when to remove chest tube | when lungs are re-expanded, and drainage is minimal |
| how to remove chest tube | valsalva maneuver (hold breath and bear down), apply occlusive dressing, chest x-ray (30-60 mins post removal), monitor for respiratory distress |
| pulmonary embolus | blockage of one more more pulmonary arteries by a thrombus, fat or air embolus or tumor tissue |
| causes of a pulmonary embolus | deep vein thrombosis, atrial fib, post-surgery or child birth |
| clinical manifestations of pulmonary emblolus | hemoptysis, chest pain (worse on inspiration), dyspnea, tachycardia, crackles and wheezes, hypoxemia |
| pulmonary embolus diagnosis | D-Dimer assay, clinical signs and symptoms, high resolution multidetector CT angio, spiral (helical) CT scan (gold standard) |
| pulmonary embolus prevention | assess for risk of VTE on admit, if risk for bleeding use SCDs, ROM and prophylactic anticoagulant therapy |
| pulmonary embolism treatment | oxygen, heparin and lovenox, thrombolytics - tPA, embolectomy, vena cava filters |
| contraindications of lung transplant | malignancy within last 2 years, chronic active hepatitis, hepatitis C, HIV, liver failure, renal failure and current smoker |
Created by:
ebrewer12
Popular Nursing sets