RNSG 2432 Exam 1 complete 179
answers graded A+.
RNSG 2432 Exam 1 complete 179
answers graded A+.
Pleural effusion - ANSWER- a collection of excess fluid in the pleural space
caused by: CHF, liver disease, renal disease, lupus, rheumatoid arthritis, pneumonia,
TB, lung cancer
Transudative pleural effusion - ANSWER- non-inflammatory; fluid is going from one
area to another due to increased capillary pressure or decreased plasma
albumin/protein
example: CHF, liver disease
Exudative pleural effusion - ANSWER- inflammatory; capillaries become more
permeable in visceral pleura due to infectious or inflammatory process, leading to
increased accumulation of fluid in pleural space
Caused by: lupus, RA, pneumonia, tb, lung cancer, ARDS
Pleurodesis - ANSWER- instillation of chemical agent (doxycycline) into pleural space to
create inflammatory response (scar tissue) to adhere the visceral and parietal pleura
mainly for terminal patients, sometimes for spontaneous pneumothorax
,RNSG 2432 Exam 1 complete 179
answers graded A+.
- pleuritic chest pain
- SOB, dyspnea
- increased RR, tachycardia
- hesitant to take deep breaths due to sharp pain
- decreased breath sounds on affected side
Traumatic pneumothorax - ANSWER- - accumulation of air into pleural space due to
blunt or penetrating trauma of the chest wall/lungs
- 3 types: closed, open, iatrogenic
Closed pneumothorax - ANSWER- - traumatic pneumothorax with no opening from
external chest
- occurs in crashes, falls, MVAs, CPR, fractured ribs
Open pneumothorax - ANSWER- - traumatic pneumothorax with an opening from
external chest wall into pleura
- occurs in stabbings, GSWs, impalement injury
Iatrogenic pneumothorax - ANSWER- - traumatic pneumothorax caused by puncture or
laceration of visceral pleura during medical tx
- occurs in central line placement, thoracentesis, lung biopsy, bronchoscopy, and
mechanical ventilation
Tension pneumothorax - ANSWER- air/blood/fluid rapidly enters pleural space and
unable to escape, leading to lung collapse - emergent
Tension pneumothorax pathophysiology - ANSWER- increase in intrapleural pressure
leads to compression of lung to other side, compressing against trachea, heart, aorta,
esophagus; ventilation and cardiac output greatly compromised
, RNSG 2432 Exam 1 complete 179
answers graded A+.
Flail chest - ANSWER- - occurs when 3+ consecutive ribs are fractured in multiple
places
- segment of chest wall becomes "free-floating"
- sucked in with inspiration and out with expiration
Flail chest treatment - ANSWER- - O2
- elevate HOB
- intercostal nerve block or epidural analgesia
- splint affected area
- intubation and positive pressure ventilation
- rib plating surgery (ORIF)
760 mm Hg - ANSWER- normal atmospheric pressure
Chest tube insertion - ANSWER- - 2nd or 3rd intercostal space for pneumothorax
- 6th to 8th intercostal space for hemothorax
Heimlich valve - ANSWER- a one-way flutter valve through which air can escape from
the chest cavity but cannot re-enter it; usually used with spontaneous pneumothorax
Chest tube insertion supplies - ANSWER- - chest tube insertion tray
- sterile gloves and gown
- chest tube
- local anesthetic
- betadine or chlorprep
- 0 silk suture on large curved needle
- 4x4 gauze pads
- vaseline gauze
- 3" silk tape
- collection system
- 1000cc bottle of sterile water
- wall suction
- suction tubing
Chest drainage nurse management - ANSWER- - obtain informed consent
- keep drainage system 2-3 feet below client's chest
- keep tubing patent (no kinks or clots)
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