MSN 377 Exam 3 Questions and Answers Latest Update 2025
normal pH - Answers 7.35-7.45
normal PaCO2 - Answers 35-45
normal HCO3 - Answers 22-28
ROME - Answers respiratory opposite
metabolic equal
respiratory = CO2
metabolic = HCO3 - Answers
risk factors for spontaneous pneumothorax? - Answers smoker, young males, tall with thin
chest wall, hx of previous pneumo, family component
what are the 2 types of pneumothorax? - Answers spontaneous and Iatrogenic
Primary vs secondary spontaneous pneumothorax - Answers Primary: not sure why, happens all
on its own, rupture of blebs (usually at apex of lung)
Secondary: due to comorbid condition (COPD, CF, asthma, pneumonia)
What causes Iatrogenic Pneumothorax? - Answers Hospital acquired!! due to med procedure
-laceration or puncture due to procedure
-insertion of sub clav catheter
-thoracentesis
-lung biopsy
-Barotrauma (pressure trauma-high PEEP)
-esophageal procedure
What is a closed/simple pneumothorax? - Answers no external chest wound (high PEEP, ARDS,
Blebs)
What is open pneumothorax? - Answers air enters pleural space through opening in chest wall
(sucking chest wound)
What do you do with sucking chest wound? - Answers cover immediately, 4x4 vaseline gauze
(vent dressing)
, Is a tension pneumothorax a medical emergency? - Answers yes! this is the worst case scenario
what type of pneumothorax is a tension pneum more likely to develop? - Answers closed
what is the presentation of tension pneumo? - Answers mediastinal shift
-hypotension
-absent breath sounds
-JVD
-air hunger, agitated even violent
-marked tachycardia
-cyanotic
what is mediastinal shift? - Answers movement of heart and great vessels to uninjured side with
inspiration
in what other case can you get a tension pneumo? - Answers when the chest tube is clamped
what leads to death in a tension pneumothorax? - Answers great vessel compression which =
decreased CO
Hemothorax - Answers blood in pleural space
chylothorax - Answers lymph fluid in pleural space
what is the tx for pneumothorax? - Answers chest tube insertion
tx for hemo or chylo thorax? - Answers chest tube or thoracentesis
what are the treatments for recurrent spontaneous pneumo? - Answers partial pleuroectomy
(take window of pleura) or pleurodecesis (staple together or give meds that will make the layers
stick together (talc or doxycycline))
what is the movement of flail chest? - Answers paradoxic (moves in opposite direction on
affected side)
-will look wavy
assessment for flail chest - Answers start with ABCs, may need IV fluids for CO
What constitutes a flail chest? - Answers 3 or more adjacent rib fractures in 2 or more places
clinical manifestations of flail chest - Answers -splinting, guarding
normal pH - Answers 7.35-7.45
normal PaCO2 - Answers 35-45
normal HCO3 - Answers 22-28
ROME - Answers respiratory opposite
metabolic equal
respiratory = CO2
metabolic = HCO3 - Answers
risk factors for spontaneous pneumothorax? - Answers smoker, young males, tall with thin
chest wall, hx of previous pneumo, family component
what are the 2 types of pneumothorax? - Answers spontaneous and Iatrogenic
Primary vs secondary spontaneous pneumothorax - Answers Primary: not sure why, happens all
on its own, rupture of blebs (usually at apex of lung)
Secondary: due to comorbid condition (COPD, CF, asthma, pneumonia)
What causes Iatrogenic Pneumothorax? - Answers Hospital acquired!! due to med procedure
-laceration or puncture due to procedure
-insertion of sub clav catheter
-thoracentesis
-lung biopsy
-Barotrauma (pressure trauma-high PEEP)
-esophageal procedure
What is a closed/simple pneumothorax? - Answers no external chest wound (high PEEP, ARDS,
Blebs)
What is open pneumothorax? - Answers air enters pleural space through opening in chest wall
(sucking chest wound)
What do you do with sucking chest wound? - Answers cover immediately, 4x4 vaseline gauze
(vent dressing)
, Is a tension pneumothorax a medical emergency? - Answers yes! this is the worst case scenario
what type of pneumothorax is a tension pneum more likely to develop? - Answers closed
what is the presentation of tension pneumo? - Answers mediastinal shift
-hypotension
-absent breath sounds
-JVD
-air hunger, agitated even violent
-marked tachycardia
-cyanotic
what is mediastinal shift? - Answers movement of heart and great vessels to uninjured side with
inspiration
in what other case can you get a tension pneumo? - Answers when the chest tube is clamped
what leads to death in a tension pneumothorax? - Answers great vessel compression which =
decreased CO
Hemothorax - Answers blood in pleural space
chylothorax - Answers lymph fluid in pleural space
what is the tx for pneumothorax? - Answers chest tube insertion
tx for hemo or chylo thorax? - Answers chest tube or thoracentesis
what are the treatments for recurrent spontaneous pneumo? - Answers partial pleuroectomy
(take window of pleura) or pleurodecesis (staple together or give meds that will make the layers
stick together (talc or doxycycline))
what is the movement of flail chest? - Answers paradoxic (moves in opposite direction on
affected side)
-will look wavy
assessment for flail chest - Answers start with ABCs, may need IV fluids for CO
What constitutes a flail chest? - Answers 3 or more adjacent rib fractures in 2 or more places
clinical manifestations of flail chest - Answers -splinting, guarding
