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pneumothorax occurs when air collects in the pleural space, causing the lungs to collapse
- negative to positive pressure
dyspnea, decreased, decreased, hyperresonance Manifestations of Pneumothorax
- ______ (difficulty breathing)
- _______ movement of involved wall
- ______ to absent breath sounds
- _________ to percussion
cover, stabilize, chest tube Intervention for Pneumothorax
pre-hospital care
- ________ wound with occlusive dressing
- _________ impaled object with bulky dressing
acute care
- ______ ______ insertion with chest drainage system
open, closed categories of pneumothorax
open pneumothorax air entering through an opening in the chest wall
closed pneumothorax air can enter the pleural cavity from internal airways, no opening in chest
wall
types of pnuemothorax - tension
- spontaneous
- iatrogenic
- hemothorax
- chylothorax
tension pneumothoraxair in the pleural space that doesn't escape
,- increased air shifts organs and increases intrathoracic pressure
cyanosis, hunger, agitation, emphysema, distention, hyperresonance, tracheal, good, dyspnea,
tachy, diaphoresis, decreased Manifestations of Tension Pneumothorax
- ______ (skin)
- air ______
- extreme ______
- subQ ______
- neck vein ________
- ________ to percussion
- _________ deviation to _______ side (late sign)
- severe ______
- marked ______cardia
- profuse _________
- __________ to absent breath sounds
needle decompression with chest tube insertion intervention for tension pneumothorax
- MEDICAL EMERGENCY
spontaneous pneumothorax A pneumothorax that occurs when a weak area on the lung
ruptures in the absence of major injury, allowing air to leak into the pleural space.
- occurs d/t small blebs (air filled sacs) on the surface of the lungs
- Ex. COPD, asthma, cystic fibrosis, pneumonia
iatrogenic pneumothorax Pneumothorax that occurs as a complication of a surgery or
medical procedure.
Ex. transthoracic needle aspiration, subclavian catheter insertion, pleural biopsy, transbronchial
lung biopsy, barotrauma, esophageal procedures
hemothorax accumulation of the blood in the pleural space from injury to chest wall,
diaphragm, lung, blood vessels, or mediastinum
chest tube, autotransfusion Interventions for Hemothorax
- immediate insertion of ____ ______
- ________ of blood
chylothorax a condition marked by lymphatic fluid in the pleural space caused by a leak in the
thoracic duct.
conservative, octreotide, surgery, pleurodesis Intervention for Chylothorax
- ________ treatment (chest drainage, bowel rest, diet)
- _________ (reduces flow of lymphatic fluid)
- ________ (thoracic duct ligation)
- _________ (artifical production of adhesions between parietal and visceral pleura)
diaphragmatic tear Tearing of diaphragm
, bowel sounds in chest manifestations of diaphragmatic rupture/tear
flail chest fracture of 3 or more consecutive ribs, in 2 or more separate places causing an
unstable segment
paradoxical, WOB, ventilation, rapid, shallow, tachy, asymmetric, uncoordinated, splinting,
crepitus, respiratory Manifestations of Flail Chest
- ________ movement during breathing
- increased _____
- inadequate _______
- _____, ______ respirations
- ______cardia
- ________ and _______ movement of thorax
- chest _______
- _______
- _________ distress
paradoxical movement a section of the chest that moves in the opposite direction to the
rest of the chest during the phases of respiration
crepitus a crackling or grating sound usually of bones
cardiac tamponde blood rapidly collects in pericardial sac, compresses myocardium because
pericardium doesn't stretch, prevents ventricles from filling
muffled, distant, hypo, distention, increased Manifestations of Cardiac Tamponade
- ______, _______ heart sounds
- ______tension
- neck vein _______
- ________ CVP
guarding, splinting, hard, decreased, abrasions, pain, hematemesis, hematuria, shock, umbilicus,
flanks, bruits, nausea, rebound Manifestations of Abdominal Trauma
- _______ and _______ of abdominal wall (indicates peritonitis)
- ________, _______ abdomen (indicates abdominal bleeding)
- _________ or absent bowel sounds
- _________ or bruising over abdomen
- abdominal ______
- _________ or ________
- signs of hypovolemic ________ (decreased BP and LOC, increased HR, tachypnea)
- bruising around _______ (Cullen Sign)
- bruising around _______ (Turner Sign)
bruits
- ________ and vomiting
- ________ tenderness