MDC 4 EXAM 2 study guide With 100% Verified
Complete Solutions UPDATED!!!
, lOMoAR cPSD| 47061011
MDC 4 EXAM 2
Chest Injury and Complex Respiratory
● Pneumothorax S/S, nsg assessment, indications
○ Air enters the pleural space and causes a loss of negative pressure in the chest cavity,
leading to lung collapse. Air enters on inspiration and cant get out!
○ Risk factors: occlusion of chest tube, vent and rib fractures
○ S/S
■ Diminished breath sounds on the affected side, asymmetrical chest expansion,
deviated trachea to unaffected side, low CO2, low BP, tachycardia, JVD,
tachypnea, anxiety
○ Treatment
■ Simple: Occlusive dressing with chest tube insertion.
■ Tension: needle decompression thoracostomy ○ Assessment:
■ Vitals, labs, CO2 levels, cardiac, respiratory, ABG
● Rib Fracture S/S, assessment ○ From trauma, sports, GSW, etc.
○ Problem is the trauma can cause punctured liver, spleen, lung contusion or lacerations that
can compromise blood and the vasculature from a small ink or scratch.
■ Any trauma of chest can lead to hemothorax ○ Patient will have PAIN! Will
need heavy pain medication.
○ Teach patients how to splint when coughing.
○ Will need vitals, cardiac and respiratory assessments.
○ Watch for bruising!
○ Simple will need to heal on its own.
○ Prevent complications with exercise and breathing.
● Flail Chest S/S, assessment, tx on a vent
○ Will have 2-3 fractures of the ribs causing free floating segment
○ S/S
■ Paradoxical chest movements
■ Dyspnea
■ Cyanosis
■ Low BP
■ Elevated HR
○ Treatment: place patient on vent and intubate! PEEP to open alveoli.
Complication that must be monitored for: PNEUMOTHORAX
● ARDS
○ Occurs after lung injury- direct or indirect causing inflammation that increases alveoli to
allow entry of fluid.
, lOMoAR cPSD| 47061011
○
○ Causes: shock, trauma, nervous system injury, emboli, infection, toxic gas inhalation,
aspiration, blood transfusions, bypass, near drowning incident,sepsis.
○ Trigger is systemic inflammatory responses
○ Often called non cardiac related pulmonary edema
○ S/S
■ Refractory hypoxemia
■ SOB,d dyspnea
■ Tachycardia
■ Cyanosis
■ Bilateral pulmonary edema
■ Crackles
■ Pink frothy sputum
■ X Ray with broken glass lung appearance
○ Treatment
■ Prone patient
■ PEEP needed on vent
● COMPLICATIONS: pneumo and low BP
■ Steroids and fluids
■ Treat cause
○ Care
■ Airway
■ Cardiac monitoring
■ Vent
● Post Op complications of chest surgery and emergency treatment
○ Hemothorax: chest tube
○ Hypovolemic Shock or hypovolemia: fluids, blood and blood products,
○ Hemorrhage: pt goes to OR
● Tx of patients on a vent and troubleshooting measures, nursing interventions, precautions for
prevention of VAP/ ventilator acquired PN
○ While patient is on the Vent
■ Have ambu bag at bedside incase vent acts up- can alway bag valve them if
needed!
■ Assess respiratory function every 2 hrs
■ Monitor labs
■ Promote communication
■ Pain management
■ Turning every 2 hrs
■ Sterility when suctioning
■ Sputum color
■ Nutrition
Complete Solutions UPDATED!!!
, lOMoAR cPSD| 47061011
MDC 4 EXAM 2
Chest Injury and Complex Respiratory
● Pneumothorax S/S, nsg assessment, indications
○ Air enters the pleural space and causes a loss of negative pressure in the chest cavity,
leading to lung collapse. Air enters on inspiration and cant get out!
○ Risk factors: occlusion of chest tube, vent and rib fractures
○ S/S
■ Diminished breath sounds on the affected side, asymmetrical chest expansion,
deviated trachea to unaffected side, low CO2, low BP, tachycardia, JVD,
tachypnea, anxiety
○ Treatment
■ Simple: Occlusive dressing with chest tube insertion.
■ Tension: needle decompression thoracostomy ○ Assessment:
■ Vitals, labs, CO2 levels, cardiac, respiratory, ABG
● Rib Fracture S/S, assessment ○ From trauma, sports, GSW, etc.
○ Problem is the trauma can cause punctured liver, spleen, lung contusion or lacerations that
can compromise blood and the vasculature from a small ink or scratch.
■ Any trauma of chest can lead to hemothorax ○ Patient will have PAIN! Will
need heavy pain medication.
○ Teach patients how to splint when coughing.
○ Will need vitals, cardiac and respiratory assessments.
○ Watch for bruising!
○ Simple will need to heal on its own.
○ Prevent complications with exercise and breathing.
● Flail Chest S/S, assessment, tx on a vent
○ Will have 2-3 fractures of the ribs causing free floating segment
○ S/S
■ Paradoxical chest movements
■ Dyspnea
■ Cyanosis
■ Low BP
■ Elevated HR
○ Treatment: place patient on vent and intubate! PEEP to open alveoli.
Complication that must be monitored for: PNEUMOTHORAX
● ARDS
○ Occurs after lung injury- direct or indirect causing inflammation that increases alveoli to
allow entry of fluid.
, lOMoAR cPSD| 47061011
○
○ Causes: shock, trauma, nervous system injury, emboli, infection, toxic gas inhalation,
aspiration, blood transfusions, bypass, near drowning incident,sepsis.
○ Trigger is systemic inflammatory responses
○ Often called non cardiac related pulmonary edema
○ S/S
■ Refractory hypoxemia
■ SOB,d dyspnea
■ Tachycardia
■ Cyanosis
■ Bilateral pulmonary edema
■ Crackles
■ Pink frothy sputum
■ X Ray with broken glass lung appearance
○ Treatment
■ Prone patient
■ PEEP needed on vent
● COMPLICATIONS: pneumo and low BP
■ Steroids and fluids
■ Treat cause
○ Care
■ Airway
■ Cardiac monitoring
■ Vent
● Post Op complications of chest surgery and emergency treatment
○ Hemothorax: chest tube
○ Hypovolemic Shock or hypovolemia: fluids, blood and blood products,
○ Hemorrhage: pt goes to OR
● Tx of patients on a vent and troubleshooting measures, nursing interventions, precautions for
prevention of VAP/ ventilator acquired PN
○ While patient is on the Vent
■ Have ambu bag at bedside incase vent acts up- can alway bag valve them if
needed!
■ Assess respiratory function every 2 hrs
■ Monitor labs
■ Promote communication
■ Pain management
■ Turning every 2 hrs
■ Sterility when suctioning
■ Sputum color
■ Nutrition
