WorksheetsTRAUMATIC CHEST INJURY, ACUTE RESPIRATORY FAILURE, PULMONARY VAS
Total questions: 72
Worksheet time: 1hrs 3mins
This refers to the obstruction of the pulmonary artery or
one of its branches by a blood clot (thrombus) that
originates somewhere in the venous system or in the right
side of the heart.
(a)
is due to a clot or
thrombus from the deep veins of the lower legs.
(a)
consist of materials that usually
gain access to the venous system then to the pulmonary
circulation. Eventually when it reaches the vessel‘s caliber
that is too small or pre- passage forms a plug occluding
the lumen and obstructing perfusion.
(a)
Occurs when there is venous thrombi shiftly from the low
extremity, most common pulmonary embolism
(a)
causes of pulmonary embolism
Fat embolism. Air embolism
multiple trauma
immobility
hypercoaguability
manifestations of pulmonary embolism
tachycardia
air hunger
Feeling of impending doom
barrel chest, dyspnea, and weight loss
manifestations of pulmonary embolism
Productive cough
Low-grade fever
Pleural Effusion
Minimal inflammation
first symptom of pulmonary embolism, which may
be accompanied with anginal or pleuritic chest pain.
(a)
Less common signs include in pulmonary embolism
Massive Hemoptysis
Splinting of the chest
Leg edema
Cyanosis, syncope, and distended neck veins
barrel chest, dyspnea, and weight loss
diagnostic exam in pulmonary embolism
Ventilation - perfusion scan
Pulmonary Arteriography
ctpa
pulmonary function test
diagnostic exam in pulmonary embolism
cxr
ecg
abg
frc
helps distinguish your pulmonary embolism especially
when it comes in relation to myocardial infarction
(a)
detects the presence of pulmonary embolism
(a)
Small emboli can be resolved within
(a)
To have adequate cardiopulmonary function in pulmonary embolism, what do do?
(a)
general management for pulmonary embolism
Oxygen therapy STAT
Early ambulation post op
Monitor obese patient
Broad spectrum antibiotics
GENERAL MANAGEMENT PULMONARY EMBOLISM
Do not massage legs
Relieve pain-analgesics and heparin
Head Of Bed elevated
cpt
insertion of a
device to filter the blood returning to
the heart and lungs and that the
formed emboli would be removed
(a)
nursing intervention, pulmonary embolism
Active leg exercises
Early ambulation
Use of elastic compression stockings
Increased fluid intake
NURSING INTERVENTIONS PULMONARY EMBOLISM
Avoid of leg - crossing and sitting for prolonged periods of
time.
Drink fluids
MOSTURE THERAPY
cpt
Complication of chest trauma occurring when 3 or more
adjacent ribs are fractured at two or more sites, resulting
in free-floating rib segments.
(a)
is described as a situation in which a portion of
the rib cage is separated from the rest of the chest wall
usually this is due to a severe blood trauma.
(a)
● Result to free-floating rib segment, and chest wall loses its stability
● Free-floating rib segments cause the chest wall to lose its stability
(a)
flail chest manifestations
Severe dyspnea; rapid, shallow, grunty breathing; paradoxical
chest motion. The chest will move INWARDS on inhalation and
OUTWARDS on exhalation.
Cyanosis, possible neck vein distension, tachycardia,
hypotension
Decrease oxygenation that will cause difficulty of breathing.
low grade fever
abg diagnostics for flail chest results
PO2 decreased
PCO2 elevated
pH decreased
PH increased
general management for for flail chest
supportive, Internal stabilization with a volume cycled ventilator
narcotics, sedatives
Control of Pain
Clearing secretions from the lungs
Early ambulation post op
general management for flail chest
Maintain an open airway: suction secretions
Monitor mechanical ventilation, turning, coughing, and deep breathing
Monitor for signs of shock: HYPOTENSION,
TACHYCARDIA.
Head Of Bed elevated
- The most common type of closed pneumothorax; air
accumulates within the pleural space without an obvious
cause. Rupture of a small bleb on the visceral pleura most
frequently produces this type of pneumothorax.
- may occur on an healthy individual
(a)
Air enters the pleural space through an opening in the
chest wall; usually caused by stabbing or gunshot wound.
● May occur with trauma or procedures
● Often accompanied by hemothorax -AKA ―sucking wound
(a)
This can develop from either simple or traumatic
pneumothorax.
(a)
Air enters the pleural space with each inspiration but
cannot escape; causes increased intrathoracic pressure
and shifting of the mediastinal contents to the unaffected
side (mediastinal shift).
(a)
Occurs when air is drawn into the pleural space from a
lacerated lung
(a)
pneumothorax manifestations
Sudden pain, tachypnea, Chest discomfort
Air hunger, Increased tympany on the chest wall
Decreased breath sounds on auscultation, Mediastinal shift
cyanosis
diagnostics result for pneumothorax
Chest x-ray reveals area and degree of Pneumothorax
pCO2 elevated
pH decreased
pH increased
treatment for spontaneous pneumothorax
(a)
Treatment is usually conservative for spontaneous
pneumothorax when there‘s?
- No sign of increased pleural pressure
- Lung collapse less than 30%
- No dyspnea or indication of physiologic
compromise
- decreased ph
treatment for traumatic pneumothorax
thoracostomy tube
insertion
chest drainage
suction
surgical
repair
treatment for tension pneumothorax
(a)
pneumothorax nursing intervention
Provide nursing care for the client with an endotracheal
tube: suction secretions, vomitus, blood from nose, mouth,
throat, or via endotracheal tube; monitor mechanical
ventilation.
Restore/promote adequate respiratory function.
Assist with thoracentesis and provide appropriate nursing
care.
Maintain patent airway
pneumothorax nursing intervention
Assist with insertion of a chest tube to water-seal drainage
and provide appropriate nursing care.
Continuously evaluate respiratory patterns and report any
changes.
Provide relief/control of pain. (opiod analgesics)
Monitor serum electrolytes levels
pneumothorax nursing intervention
Maintain patent airway
Monitor serum electrolytes levels
Administer narcotics/analgesics/sedatives as ordered and
monitor effects
Position client in high-fowler‘s position
pneumothorax complications
Cardiac tamponade
Compression of the heart as a result of fluid within the
pericardial sac
Acute respiratory failure
air hunger
pneumothorax complications
Sudden and life-threatening deterioration of the gas
exchange function of the lungs.
Severe dyspnea
rapid, shallow, grunty breathing
cyanosis
ACUTE RESPIRATORY FAILURE CAUSES
CNS depression -head trauma, sedatives
CardioVascular diseases -MI, CHF, pulmonary emboli
Airway irritants -smoke, fumes
allergens
acute respiratory failure causes
Endocrine and metabolic disorders -myxedema, metabolic
alkalosis
Thoracic abnormalities -chest trauma, pneumothorax
Fat embolism. Air embolism
Immobility
acute respiratory failure manifestations
Restlessness
Dyspnea
Cyanosis
Cardiac tamponade
acute respiratory failure manifestations
Altered respiration
Altered mentation
Tachycardia
Thoracic abnormalities
acute respiratory failure manifestations
Cardiac arrhythmias
Respiratory arrest
cns depression
Endocrine and metabolic disorders
diagnostic exam result in acute respiratory failure
Pulmonary function test- pH below 7.35
CXR -pulmonary infiltrates
ECG - might cause arrhythmias
PaCO2 of less than 50mmHG
general management for acute respiratory failure
focuses on
correcting hypoxemia and preventing respiratory acidosis.
oxygenation
Position client in high-fowler‘s position
Provide relief/control of pain.
general management for patient with acute respiratory failure if the patient
isn‘t intubated and mechanically ventilated, to help keep airway patent
(a)
general management for patient with acute respiratory failure to increase lung volume oxygen therapy, to promote oxygenation and
raise partial pressure of arterial oxygen.
(a)
general management for patient with acute respiratory failure if needed, to provide adequate oxygenation and reverse acidosis.
(a)
general management for patient with acute respiratory failure if the patient doesn‘t respond to treatment, to force the airways open, promoting oxygen and preventing alveoli collapse
(a)
drugs for acute respiratory failure
antibiotics
bronchodilators
corticosteroids
expectorants
drugs for acute respiratory failure
Positive inotropic agents
Vasopressors
diuretics
mast cell stabilizers
drugs for acute respiratory failure
Diuretics
Opioids
Anxiolytics
expectorants
drugs for acute respiratory failure
Sedatives
expectorants
mast cell stabilizers
antipscyhcotic
nursing intervention for acute respiratory failure
maintain patent airway
Administer O2 to maintain PaCO2 at more than 50 mmHg
Suction airways as required
position to high fowlers
nursing intervention for acute respiratory failure
Monitor serum electrolytes levels
Administer care of patient on mechanical ventilation
position on high fowlers
chest physiotherapy
drug for acute respiratory failure to maintain airway patency
(a)
drug for acute respiratory failure to treat infection
(a)
drug for acute respiratory failure to decrease inflammation
(a)
drug for acute respiratory failure to maintain bp
(a)
drug for acute respiratory failure to reduce edema and fluid overload
(a)
drug for acute respiratory failure to to reduce respiratory rate and
promote comfort by relieving anxiety
(a)
drugs for acute respiratory failure to reduce
anxiety
(a)
drugs for acute respiratory failure to if the patient requires
mechanical ventilation and is having difficulty tolerating it.
(a)
Positive inotropic agents to increase cardiac output
(a)
anxiolytics example
(a)
sedatives example
(a)
Partial or complete collapse of the lung due to an accumulation
or air or fluid in the pleural space. Occurs when the parietal or
visceral pleural is breached and the pleural space is exposed to
a positive atmospheric pressure.
(a)
