AHN 447 Exam 3 Practice Questions and Answers

AHN 447 Exam 3 Practice Questions and Answers What are the clinical manifestations of a pulmonary contusion? - ANSWER-MAY BE ASYMPTOMATIC AT FIRST decreased breath sounds or crackles and wheezes over the affected area bruising over the injury dry cough tachycardia ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/98 tachypnea dullness to percussion bloody sputum initial CXR normal--CXR with opacities after several days *can lead to respiratory failure What is the pathophysiology of a pulmonary contusion? - ANSWER-occurs most often by rapid deceleration during car crashes Hemorrhage and edema occur in and between the alveoli, reducing both lung movement and the area available for gas exchange. ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/98 Localized inflammation can cause further damage. The pt becomes hypoxemia and dyspneic (SOB). What position should you place the pt in who has a pulmonary contusion? - ANSWER-Place the pt in moderate-Fowler's position. When side-lying, the "good lung down" position may be helpful. What are rib fractures most often caused by? - ANSWER-direct blunt trauma to the chest wall (The force applied to the ribs fractures them and drives the bone ends into the chest) What is the pt at risk for with a rib fracture? - ANSWER-DEEP CHEST INJURY (pulmonary contusion, pneumothorax, hemothorax) What is flail chest? - ANSWER-Flail chest is the result of fractures of at least 2 neighboring ribs in 2 or more places causing PARADOXICAL CHEST WALL MOVEMENT (inward movement of the thorax during inspiration, outward movement during expiration) ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/98 It usually involves one side of the chest and results from blunt chest trauma. What clinical manifestations are most often seen with a flail chest? - ANSWER-paradoxical chest movement SOB cyanosis tachycardia hypOtension pain ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/98 *work of breathing is increased from the paradoxical movement of the involved segment of the chest wall What interventions should you implement as the RN of a pt with flail chest? - ANSWER-Monitor the pt's VS and F&E balance (to intervene if shock or hypovolemia occurs) If he/she has a lung contusion, provide O2 prn and give IV fluids as pres