NURS 642 /AGACNP EXAM 1 2024/ACTUAL EXAM WITH 100% CORRECT ANSWERS/LATEST UPDATE 2024
Pneumothorax - Correct Answer-occurs when air is allowed into the pleural space
Caused by trauma, medical procedures, or spontaneously - Correct Answer- penumothorax
perforation of chest wall or pleur...
NURS 642 /AGACNP EXAM 1 2024/ACTUAL EXAM WITH 100% CORRECT ANSWERS/LATEST UPDATE 2024 Pneumothorax - Correct Answer -occurs when air is allowed into the pleural space Caused by trauma, medical procedures, or spontaneously - Correct Answer - penumothorax perforation of chest wall or pleura: trauma (sucking chest), blunt (air enters form lung to pleura), iatrogenic, - Correct Answer -causes of penumothorax Pneumothorax risk factors - Correct Answer -trauma, iatrogenic, intrinsic lung disease, young, thin males, smoking, HIV with penumocystis jiroveci penumonia Iatrogenic causes - Correct Answer -Central line , bronchoscopy(with needle bx) needle insertion (bx liver, lung, thoracentesis) surgery (chest,neck abdominal) Mechanical ventilation Tension Pneumothorax - Correct Answer -air pressure builds within the pleura space (unable to exit) pressure rises lung collapses causing shifting of the mediastinum and impairment of venous blood return to the heart - Correct Answer -tension pneumothorax Pneumothorax HPI - Correct Answer -acute onset of dyspnea and pain. agitation or apprehension may cause tachypnea, tachycardia developing a tension pneumothorax - Correct Answer -hemodynamic instability (hypotension, CV collapse with distended neck veins, tracheal shift) and mediastinal shift may be noted. reduced breath sounds, splinting, reduced respiratory expansion, tracheal/mediastinal shift, subcutaneous empheysema, hemodynamic instability with impaired venous return - Correct Answer -tension pneumothorax mainstay for diagnosing pneumothorax - Correct Answer -CXR what is the preferred position of CXR for penumothorax - Correct Answer -upright position increased translucency, visible lining collapse demarcation, mediastinal shift. (looks like lung pushed inwards) - Correct Answer -findings on CXR for pneumothorax Diff. diagnosis for penumothorx include (think of causes for acute sob) - Correct Answer -PE and Pneumonia pneumothorax diagnostic criteria - Correct Answer -significant history and exam findings may be sufficient to proceed with treatment without CXR. pneumothorax in a stable patient - Correct Answer -CXR is diagnostic criteria Pneumothorax goals of care - Correct Answer -stabilization and intervention in the unstable pt pneumothorax goals of care for the stable patient - Correct Answer -decision made to intervene or monitor based on the amount of lung volume lost. tension pneumothorax Acute management - Correct Answer -emergent intervention : needle decompression, 14-16G needed, 2nd ICS, anterior at MCL and chest tube placement - Correct Answer -tension penumothrox management open penumothorax - Correct Answer -three sided occlusive dressing placement until definitive treatment can be performed (surgical permanent chest tube) Acute management for the stable pneumothorax - Correct Answer -determine underling etiology and evaluate extent. decision made on percentage of lung involvement chest tube placement (thoracostomy) - Correct Answer ->20% collapse (2cm). unstable pt, 4th or 5th ICs and mid -axillary line. closed chest drainage (water seal), chest tube indication with negative pressure - Correct Answer -if water seal insufficient after 24 -48 hours, clinically unstable, persists hypoxemia/hypercapnia. surgical consideration pneumothroax - Correct Answer -not responding to other measures and reduce recurrence Mnemonic causes of pneumothorax - Correct Answer -SIT, 3As, 3Cs Spontaneous Iatrogenic Trauma Asthma Alevolitis Aids COPD Carcinoma Cyhstic fibrosis
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