NUR2755 MDC4 Final Exam Questions and Answers Rationale Included

NUR2755 MDC4 Final Exam Questions and Answers Rationale Included . Pneumothorax: air that suddenly enters the pleural space; sudden addition of air causes a loss of negative pressure and a reduction in vital capacity which can cause the lung to collapse o Types  Spontaneous/iatrogenic: not associated with trauma; blebs; Valsalva; may resolve on its own; if <15%= observation  Closed: air in the chest that has entered through a hole in the lung  Open: air in the chest that has entered through a hole in the best wall  sucking chest wound is a special type of open pneumothorax: air is sucked into the thoracic cavity through the chest wall instead of into the lungs through the airways because air follows the path of least resistance  Simple: air escapes from the injured lung into the pleural space, and negative intra-pleural pressure is lost, resulting in a partial or complete collapse of the lung  Interventions: cover the wound with occlusive dressing; chest tube insertion (monitor lung sounds after chest tube insertion); monitor respiratory and circulatory function; assess vitals, respiratory and circulatory function; pain management  Tension: air enters intrapleural space but can’t escape on expiration; increased intrathoracic pressure causes the lung on the injured side to collapse; mediastinum shifts toward the uninjured side, compressing the heart, great vessels and ultimately the opposite lung; increased intrathoracic pressured causes decreased cardiac output; hypotension  Cover the wound with occlusive dressing; immediate chest decompression (thoracotomy- use large bore needle to decompress); chest tube; monitor respiratory and circulatory function (patient will have minimal to absent breath sounds on affected side); assess lung sounds, tracheal deviation; pain management