case study

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Introduction
This paper will discuss a case study of Pritesh, a 26 years old man who is transferred from the emergency department (ED) to the high dependency unit (HDU) with the developing of a tension pneumothorax. Initially, a general description of the patient’s chief complaint which is tension pneumothorax will be introduced, following by assessments of the patient’s need. The paper will focus on the discussion of nursing care and management for the patient, and a brief summary and evaluation of the care will be given. Lastly, a conclusion of what author has learned from this case study will be present.
Patient’s chief complaint
Pritesh has a previous medical history of asthma and has experienced right-sided haemothorax as he got hit by a hockey ball during a competition. Currently, the nurse suspects that Prithesh may be developing tension pneumothorax which is a life-threatening medical emergency (Brown & Edwards, 2012). Tension pneumothorax develops when a hole in the airway structures or the chest wall allows air to enter but not leave the thoracic cavity (Rodgers, 2008). The pressure in the intrathoracic space will continue increase until the lung collapses, place tension on the heart and the opposite lung leading to respiratory and cardiac function impairment, and eventually shock may result (Professional guide to pathophysiology, 2011; Rodgers, 2008). Tension pneumothorax usually results from a penetrating injury to the chest, blunt trauma to the chest, or during use of a mechanical ventilator (Brown & Edwards, 2012; Rodgers, 2008).
Assessments
There are a number of assessments that may need to be conducted after Pritesh being admitted in HDU. First of all, Pritesh’s health history, such as pervious health history ...

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...c should be between 60-80 mmHg, heart rate should be within acceptable range of 60-110 beats/min, and central venous pressure should drop to the range of 0-6 cmH2O (Brown & Edwards, 2012; Rodgers, 2008; Swearingen, 2012). The patient’s pain score should be below 3-4 on a 0-10 pain rating scale, or absence of pain (Swearingen, 2012). The patient should be alert with no signs of agitation, and has good understanding of tension pneumothorax and interventions required (Swearingen, 2012).
Student reflection
From this case study, the author has learned that tension pneumothorax is a medical emergency that requires interventions immediately. The author has also realised that malfunctioned drainage system and chest tubes could lead to developing of tension pneumothorax. Therefore, staff education about how to assess and maintain closed drainage system is important.

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