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NUR 265 Unit 4 discussion
- Course
- ATI NUR265
- Institution
- Galen College Of Nursing
Unit 4 discussion - Medical-Surgical Nursing
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Scenario2:
G.S.,a36- y
ear-oldsecr etary,wasi nv ol
vedi namot orvehi cl
eaccidentwher eacar
dri
ft
edl ef
tofthecent erlineandst ruckherhead- on,pinningherbehi ndt hesteer ing
wheel .Shewasi ntubatedandi njurieswer eex t
ensive:bilateralflai lchest,torn
i
nnomi nateart
ery,righthemot horaxandpneumot horax,fracturedspleen,mul t
iplesmall
l
iverlacerati
ons,compoundf ract
uresofbot hlegs,andpr obablecar diaccontusi on.She
wast ak entotheoper atingr oom forr epairofheri nj
uries.G. S.wasadmi t
tedtot heICU
postop,wher eshedev elopedadul tr espi
ratorydistr
esssy ndrome( ARDS) .Shehas
bi
lateralchesttubest owat ersuctionwi thcloseddr ainage,bot hdress ingsaredr yand
i
ntact.Shehasaduodenalf eedingt ube,aFol eycat hetert odowndr ain,andadoubl e
l
umenPI CCl i
ne.
1.Expl
ai
nARDSandt
her
iskf
act
orst
hispat
i
enthasf
ordev
elopi
ngARDS.
-
ARDSalsoknownasAc ut
erespi
rator
ydis
tresssyndromeoccurswhenl
ungfluids
i
ncr
easeandcont
ainsmoreprot
ein.Thefluidbuildsupinthealv
eol
ii
nthel
ungswhen
t
hemembranebecomesmor epermeablet
olargemol ecul
es.
-Ther
iskfact
ort
hatt
hispat
i
enthasfordevelopi
ngARDSispostopi
nfect
i
on;sepsi
s,
t
raumafr
om theMVA,hemothor
ax,shock,andpneumot
hor
ax.
2.Whati
sthesi
gni
ficanceoft
heflai
lchest
?
Flai
lchestiswhent hereareatleasttwofr
acturesint heri
bsintwoormoreplaces
causi
ngpar adoxicalchestwallmovement.Thesigni ficanceoftheflailchesti
sthati
tcan
creat
eadi stur
bancet otherespir
ator
yphysiology,iti
simportantt
oassessthepat
ient
withaflai lchestforotherpossi
bleunderl
yinginjuri
es.Alsoassessf
ordyspnea,
cyanosi
s,tachycardia,andhypotensi
onont hepat i
ent.
3.Expl
ai
nhemot
hor
axandpneumot
hor
ax,howar
etheydi
ffer
ent
?
Hemothor
axi
sthecol
l
ect
i
onofbl
oodi
nthepl
eur
alcavi
ty
,br
eat
hsoundsar
e
absent
.
o Hemo-
blood,-
thor
ax:chest
.
o Br
eat
hsoundsar
eabsent
o Dul
l
nesscanbenot
edonper
cuss
ionatt
heant
eri
orandatl
eftsi
de.
o Opaci
tycanbenot
edi
nCXR
o Nol
ungmar
kingi
sseeni
nthei
mages
Pneumot
hor
axi
stheai
rint
hepl
eur
alspace
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