1. What are the clinical manifestations of a pneumothorax? Name 2 causes of pneumothorax.
Clinical manifestations of a pneumothorax are when a person has shortness of breath and pain in their chest that comes out of no where (MedicineNet.com, 2016). The patient may also experience tachycardia, rapid breathing and coughing along with fatigue (MedicineNet.com, 2016). Two causes of a pneumothorax are a chest injury such as blunt trauma or a penetrating injury to the chest like a stabbing (MayoClinic, 2016). An individual lung disease may also get one because the chances of a damaged lung collapsing is high (MayoClinic, 2016).
2. Describe the nursing management of a patient with a pneumothorax. Include symptomatology, assessment, diagnostic tests,
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The nurse should also look for these signs if the patient is brought in for a chest injury, has lung disease or on a mechanical ventilation (MayoClinic, 2016). First, the nurse should listen to the patient’s breath sounds to see if they are either absent or diminished. Typically, the diagnostic test that is used is a chest x-ray or in some instances a computerized tomography (CT scan) to be able to see images with more detail (MayoClinic, 2016). These tests can confirm if the patient does in fact have a pneumothorax. The treatment and goal when a patient has a pneumothorax is to relieve pressure in the lung to the point that it is able to re-expand (MayoClinic, 2016). A needle or a chest tube can be used to remove excess air that is preventing the lung from expanding (MayoClinic, 2016). If this does not solve the problem, surgery can be done. A doctor can surgically go into the patient using a small incision and close the hole. There are a few complications that can occur when an individual has a pneumothorax such as the patient potentially having another one and potentially needing surgery if the whole does not close and air continues to leak (MayoClinic, …show more content…
What is subcutaneous emphysema? How would you access for it?
Subcutaneous emphysema is when “air gets into tissues under the skin” (MedlinePlus, 2016). Typically seen around the chest wall or the neck. A nurse would assess for it by touching the skin and feeling for bubbles that make an abnormal crackling sound. The nurse also may see a bulging from under the skin (bubbles).
5. Calculation:
Order for: IV 0.9% normal saline at 125 mL/hour. How many Liters of fluid will the patient receive in 24 hours?
125 ml/hour X 24 Hours = 3,000 mL/hour
1000 mL= 1 Liter
3,000 mL/hour divided by 1,000 = 3 Liters
Medications Cards
Additionally, some of the general diagnostic and pulmonary function tests are distinct in emphysema in comparison to chronic bronchitis. In the case of R.S. the arterial blood gas (ABG) values are the following: pH=7.32, PaCO2= 60mm Hg, PaO2= 50 mm Hg, HCO3- = 80mEq/L. R.S.’s laboratory findings are indicative of chronic bronchitis, where the pH and PaO2 are decreased, whereas PaCO2 and HCO3- are increased, when compare to normal indices. Based on the arterial blood gas evaluation, the physician can deduce that the increased carbon dioxide is due to the airway obstruction displayed by the hypoventilation. Furthermore the excessive mucus production in chronic bronchitis hinders proper oxygenation leading to the hypoxia. On the other hand, in emphysema the arterial blood gas values would include a low to normal PaCO2 and only a slight decrease in PaO2 which tend to occur in the later disease stages.
1. Nine year old Jerry stumbled into a drug store, which is usually open late with very few attendants, gasping for breath. Blood was oozing from a small hole in his chest wall. When paramedics arrived, they said that Jerry had suffered a pneumothorax and atelectasis. Just what do both these terms mean and how do you explain his respiratory distress? How will it be treated?
Additionally, the clinical staff has shown very low level of confidence in the RR documentation on observation chart. Lack of time, laziness, lack of training and knowledge and unawareness of the importance of the respiratory assessment are main reasons to neglect this important aspect of nursing as stated in this study (Philip, Richardson, & Cohen,
Once the paramedics retrieve Marc, he will have a high concentration of salt in his blood and fluids. This means that the paramedics would treat him with the half normal saline. This is the solution with the lowest percentage of solutes (0.45% NaCl).this will increase his concentration of water throughout this body and will return his cells to their normal size. However, if the paramedics were to keep him on the half normal saline for too long, his water concentration would be too high and his solute concentration would become too low. This would mean that the paramedics would then need to switch Marc to the normal isotonic saline solution (0.9% NaCl). This would balance out both the concentration of water and solutes so that they are now equal. This would set his balance and homeostasis back to normal, thereby helping his recovery. (Johnson
HENDERSON, Y (1998) A practical approach to breathing control in primary care. Nursing Standard (JULY) 22 (44) p41
In normal breathing, the lungs expand and contract easily and rhythmically within the ribcage. To facilitate this movement and lubricate the moving parts, each lung is enveloped in a moist, smooth, two-layered membrane (the pleura). The outer layer of this membrane lines the ribcage, and between the layers is a virtually imperceptible space (the pleural space), which permits the layers to glide gently across each other. If either of your pleurae becomes inflamed and roughened, the gliding process is impeded and you are suffering from pleurisy. Pleurisy is actually a symptom of an underlying disease rather than a disease in itself. The pleurae may become inflamed as a complication of a lung or chest infection such as pneumonia or tuberculosis, or the inflammation may be caused by a slight pneumothorax or chest injury. The pleural inflammation sometimes creates a further complication by causing fluid to seep into the pleural space, resulting in a condition known as pleural effusion. However, pleurisy is not the only condition that can lead to pleural effusion, it may also be produced by diseases such as rheumatoid arthritis, liver or kidney trouble or heart failure. Even cancer spreading from the lung, breast or ovary can cause pleural effusion. If you have pleurisy, it hurts to breathe deeply or cough, and chest pain is likely to be severe. Accompanying the pain are any other symptoms associated with the underlying disorder. The pain will disappear if a pleural effusion occurs as a consequence of pleurisy, because fluid stops the layers of the pleura from rubbing against each other; however, you may become breathless as the fluid accumulates. In most cases, the risks are those of the underlying cause. A big pleural effusion can compress the lungs and cause breathlessness. Any effusion may lead to empyema. A chest X-ray examination may be required.
Unpleasant breathlessness that comes on suddenly or without expectation can be due to a serious underlying medical condition. Pneumonia can impact the very young and very old, asthma tends to affect young children, smokers are at greater risk of lung and heart disease and the elderly may develop heart failure. However, medical attention always needed by all these conditions as it can affect any age group and severe breathlessnes. There are short and long term causes of dyspnea. Sudden and unexpected breathlessness is most likely tend to be caused by one of the following health conditions. There is accumulating evidence that in many patients, dyspnea is multifactorial in causes, and that in most patients, there is no single, all-encompassing explanation for dyspnea.
Asthma is a chronic disease that makes it difficult to breathe. The airways to the lungs swell up and become inflamed, which narrows the air passageway to the lungs and the lungs cannot receive the amount of oxygen that it needs. “Mucus builds up inside the airways so you have trouble getting air in and out of your lungs.” (Pope, 2002, p.44). If the lungs do not receive the essential amount of air, it will cause a lot of distress and wheezing to the patient.
...tered if needed. The nurse will assess pulse oximetry readings, respiratory rate, and pain level. Pain will be treated with prescribed pain meds, fluids and electrolytes will be given as needed, and other meds such as bronchodilators, antibiotics, and/or antivirals will likely be prescribed. Pneumonia is very common illness but it can be fatal if not treated, so education regarding prevention and treatment is very important. Pneumococcal and influenza vaccines are available for prevention. Healthy eating and exercise are great ways to stay healthy and build a strong immune system. Proper fluid intake is very important, at least 6 to 8 glasses a day. Hand washing is the most effective way to stop the spread of infection.
Hess Dean R., M. N. (2012). Respiratory Care: Principles and Practice 12th Edition. Sudbury, MA: Jones and Bartlett Learning.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
A pneumothorax is defined as “the presence of air or gas in the plural cavity which can impair oxygenation and/or ventilation” (Daley, 2014). The development of a pneumothorax to a tension pneumothorax can be caused from positive pressure ventilation.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
...o Pneumonia, it causes respiratory failure. The treatment for this would most likely be ventilator breathing for the patient with supplemental oxygen. (Boothby, L. A. (2004)
A nursing diagnosis is not the equivalent of a medical diagnosis; however, a nursing diagnosis can be used to formulate an intervention for the patient. A nursing diagnosis includes stating the problem, the cause, and signs and symptoms seen in the patient. For example, a patient may have been given the medical diagnosis of COPD (Chronic Obstructive Pulmonary Disease), but this cannot be given as a nursing diagnosis. The proper nursing diagnosis would be: Ineffective airway clearance, related to excessive thick secretions as evidenced by coughing, gagging, and mucous. This type of diagnosis tells of an issue the nurse can solve or treat themselves using their own knowledge of the