NEW
Font size
WorksheetsThoracic Trauma
Total questions: 21
Worksheet time: 11mins
Second only to head and spinal injuries, thoracic injuries account for _______ of trauma deaths.
30%
20%
25%
35%
The anatomical structure located in the center of the thoracic cavity is the:
Mediastinum
Parietal pleura
Visceral pleura
Diaphragm
When is it beneficial to clamp a patient's chest tube?
When ordered by a physician to simulate tube removal and assess the patient's response
Whenever a patient leaves the nursing unit and cannot be monitored
When ambulating a postoperative patient with a chest tube
It is never beneficial to clamp a patient's chest tube.
New bubbling is observed in the water seal chamber after a patient with a pleural chest tube returns from a test. The nurse clamps the chest tube momentarily with a tubing clamp at the dressing site. When this is done, bubbling in the water seal stops, the next appropriate nursing action is to:
Continue to monitor the water seal chamber for bubbling every hour for the next four hours.
Do nothing. This bubbling is normal in patients with pleural chest tubes.
Remove the chest tube dressing to see if one or more eyelets of the chest tube have been pulled out of the chest.
Call the physician immediately and do not leave the patient's bedside because of the risk of respiratory failure.
Which of the following situations is likely to result in the absence of fluctuations in the chest drainage tubing?
The tubing is coiled on the bed with a straight path to the chest drain.
The tubing is blocked in some way.
The patient is receiving positive pressure ventilation.
The patient is ambulatory.
If the chest tube is pulled out of the patient's chest, and the patient had an air leak from the lung, after asking a colleague to call a physician STAT, emergency nursing management is to:
Cover the opening with a sterile dressing taped on three sides
Cover the opening with a sterile Vaseline gauze, taped securely on all sides
Leave the opening alone and monitor the patient until a physician can assess the situation.
Try to put the tube back in place as quickly as possible
A physician has just performed a thoracostomy for pleural effusion. The nurse handed the patient tubing from the drain to the physician, who attached it to the chest tube. The drain is properly filled with water and placed in an upright position below the patient's chest. The physician orders suction to the chest drain system. With a dry suction control chamber (as is present in the Atrium Oasis), how should the nurse adjust the vacuum source?
Adjust the vacuum source until the dial on the vacuum regulator reads -20mmHg
Adjust the vacuum source until constant, gentle bubbling just begins in the suction control chamber
Adjust the vacuum source until the bellows indicator is all the way to the right of the indicator window
Adjust the vacuum source until the bellows indicator reaches the arrow mark in the indicator window
In a self-contained, disposable chest drain, the amount of negative pressure transmitted to the patient by suction is determined by:
The amount of suction set on the wall vacuum regulator
The sensitivity of the high negative pressure relief valve
The dial setting on the suction control chamber
The level of water in the water seal chamber
In self-contained, disposable chest drains, the manual high negative pressure relief valve
Allows water to be added to the system without disconnecting the patient tubing
Alerts the nurse to a situation of high pressure within the system and automatically vents
Allows filtered atmospheric air into the system to offset a rise in negative pressure
Alerts the nurse to high suction levels accumulating in the system
A potentially life-threatening condition in which air and pressure rapidly accumulate in the pleural space and, if not treated, can result in a mediastinal shift is called:
An open pneumothorax
An iatrogenic pneumothorax
A tension pneumothorax
A spontaneous pneumothorax
A patient with an opening in the chest wall, such as from a gunshot, stab wound, or impalement, resulting in a "sucking chest wound," can be said to have:
An open pneumothorax
A closed pneumothorax
A hemothorax
A pleural effusion
Which of the following statements is true about intrapleural (the space between the parietal and visceral or pulmonary pleurae) pressure under normal conditions?
It is always positive.
It is negative during inhalation; positive during exhalation.
It is positive during inhalation; negative during exhalation.
It is always negative.
What is the initial management of an open pneumothorax?
promptly closing the defect with a sterile occlusive dressing
no emergency treatment is needed
emergency thorocotomy
suture of the wound
Which of these statements is true for the tension pneumothorax?
it result from large defects of the chest wall that remain open
the mediastinum is shifted to the opposite side,decreasing the venous return and compressing the opposite lung
the treatment is emergency thoracotomy
we should wait for the chest xray to comfirm the diagnosis before proceeding with the treatment
Which of the following situations would be an indication for performance of a thoracotomy in the emergency room?
penetrating abdominal trauma and no sign of life in the field
rapidly deteriorating patient with cardiac tamponade from penetrating thoracic trauma
blunt trauma to multiple organ systems with obtainable vital signs in the field but none on arrival in the emergency roam
massive hemathorax following blunt trauma to the chest
What causes the. greatest physiologic insult in patients with flail chest?
the abnormal chest wall movement
the pulmonary contusion
the massive blood loss
the multiple ribs fracture
How many types of pneumothorax are there?
4
3
5
2
What other condition can be initially confused with tension pneurnothorax?
AMI
open pneumothorax
flail chest
cardiac tamponade
A 25-year-old woman arrives in the emergency room following an automobile accident. She is acutely dyspneic with a respiratory rate of 60 breaths/min. Breath sounds. are markedly diminished on the right side. The first step in managing the patient should be to
draw arterial blood for blood gas determination
administer intravenous fluids
decompress the right pleural space
perform pericardiocentesis
How do we define a massive hemothorax?
accumulation of more than 1000ml of blood
accumulation of more than 2500ml of blood
accumulation of more than 1500ml of blood
accumulation of more than 300ml of blood
What is the mast important part in the treatment of patients with pulmonary contusion?
blood transfusions
observation and follow-up
treatment of post traumatic lung infection
emergency thoracotomy
