Pulmonary exam 2 nur 265 Questions
with Correct Answers
causes of pulmonary embolism - ANSWERS- usually caused by DVT that has been
freed and moved to the lungs. Can be air or tumor tissue.
Risk factors of PE - ANSWERSKnown DVT, PMHx of DVT or PE, FHx, Recent surgery,
Cancer, A-Fib, Immobility, Pregnancy, BCP, Smoking
Treatment of PE - ANSWERSUnfractionated heparin given IV is standard treatment.
Enoxaparin (outpatient treatment)
Transudative pleural effusions should make you think of what diagnosis? -
ANSWERSCHF, PE, cirhhros and kidney issues.
Pleural effusion causes - ANSWERS-Heart, Liver, or renal Failure
-Chest wall trauma
-TB/PE
-Complication of anticoagulant therapy after chest surgery
Symptoms of pleural effusion - ANSWERS-dyspnea on exertion
-non-productive cough
-diminshed breath sounds
-dullness to percussion
-may or may not hear crackles
Treatment for pleural effusion - ANSWERS-thoracentesis- remove fluid so lung can
expand
-sent fluid sample to lab
- chest tube can be placed
Thorancentesis - ANSWERSPt sit at edge of bed and hold breath during needle
insertion and duration.
- if blood, bleeding is concern.
-emphysema is a group of WBC. We need to prevent sepsis.
Causes of pneumothorax - ANSWERSSpontaneous
smoking
complications from existing disease
trauma
surgery
, What is a pneumothorax? - ANSWERSair in the pleural space, changes the pressure in
the thoracic cavity and decreases the surface area for oxygen exchange.
open pneumothorax (sucking chest wound) - ANSWERSAn open or penetrating chest
wall wound through which air passes during inspiration and expiration, creating a
sucking sound. wound needs to be covered.
tension pneumothorax - ANSWERSa pneumothorax with rapid accumulation of air in
the pleural space causing severely high intrapleural pressures with resultant tension on
the heart and great vessels.
Tension pneumothorax treatment - ANSWERSPrompt insertion of large-bore needle or
chest tube for decompression. Will need central line bc heart is having trouble pumping.
spontaneous pneumothorax - ANSWERSA pneumothorax that occurs when a weak
area on the lung ruptures in the absence of major injury, allowing air to leak into the
pleural space. Can occur due to changes in air pressure-scuba diving, flying, mnt
climbing. OR injury due to smoking
symptoms of pneumothorax - ANSWERS-reduced breath sounds
- affected side moves poorly with resp.
-trach deviation
-pleuritic pain
-tachypnea
-subq emphysema
symptoms of tension pneumothorax - ANSWERS- Tracheal deviation
- Distended neck veins
- Unilateral absence of breath sounds
- Cyanosis- COMPLICATION
Chest tube - ANSWERSTidaling-see on inspiration and exp.
Water- sterile water (2cm) keep at bedside
Output->70mL/hr ISSUE. Measure q hour and mark on canister
Air leak- seen w cont. tidaling in wtr seal chamber CALL MD
Assessment- asses pt resp status, vs, pain
Safety- keep canister below chest, don't pull on tubes.
Prevention of PE - ANSWERS• Passive, active ROM; ambulate soon after surgery
• Change position every 2 hours
• Anti-embolism stockings (SCD's)
• Avoid tight garters, girdles, constricting clothing
• No pillows under knees
• Comprehensive peripheral circulatory assessment
• Elevate affected limb 20 degrees above heart
• No massaging or compressing leg muscles
with Correct Answers
causes of pulmonary embolism - ANSWERS- usually caused by DVT that has been
freed and moved to the lungs. Can be air or tumor tissue.
Risk factors of PE - ANSWERSKnown DVT, PMHx of DVT or PE, FHx, Recent surgery,
Cancer, A-Fib, Immobility, Pregnancy, BCP, Smoking
Treatment of PE - ANSWERSUnfractionated heparin given IV is standard treatment.
Enoxaparin (outpatient treatment)
Transudative pleural effusions should make you think of what diagnosis? -
ANSWERSCHF, PE, cirhhros and kidney issues.
Pleural effusion causes - ANSWERS-Heart, Liver, or renal Failure
-Chest wall trauma
-TB/PE
-Complication of anticoagulant therapy after chest surgery
Symptoms of pleural effusion - ANSWERS-dyspnea on exertion
-non-productive cough
-diminshed breath sounds
-dullness to percussion
-may or may not hear crackles
Treatment for pleural effusion - ANSWERS-thoracentesis- remove fluid so lung can
expand
-sent fluid sample to lab
- chest tube can be placed
Thorancentesis - ANSWERSPt sit at edge of bed and hold breath during needle
insertion and duration.
- if blood, bleeding is concern.
-emphysema is a group of WBC. We need to prevent sepsis.
Causes of pneumothorax - ANSWERSSpontaneous
smoking
complications from existing disease
trauma
surgery
, What is a pneumothorax? - ANSWERSair in the pleural space, changes the pressure in
the thoracic cavity and decreases the surface area for oxygen exchange.
open pneumothorax (sucking chest wound) - ANSWERSAn open or penetrating chest
wall wound through which air passes during inspiration and expiration, creating a
sucking sound. wound needs to be covered.
tension pneumothorax - ANSWERSa pneumothorax with rapid accumulation of air in
the pleural space causing severely high intrapleural pressures with resultant tension on
the heart and great vessels.
Tension pneumothorax treatment - ANSWERSPrompt insertion of large-bore needle or
chest tube for decompression. Will need central line bc heart is having trouble pumping.
spontaneous pneumothorax - ANSWERSA pneumothorax that occurs when a weak
area on the lung ruptures in the absence of major injury, allowing air to leak into the
pleural space. Can occur due to changes in air pressure-scuba diving, flying, mnt
climbing. OR injury due to smoking
symptoms of pneumothorax - ANSWERS-reduced breath sounds
- affected side moves poorly with resp.
-trach deviation
-pleuritic pain
-tachypnea
-subq emphysema
symptoms of tension pneumothorax - ANSWERS- Tracheal deviation
- Distended neck veins
- Unilateral absence of breath sounds
- Cyanosis- COMPLICATION
Chest tube - ANSWERSTidaling-see on inspiration and exp.
Water- sterile water (2cm) keep at bedside
Output->70mL/hr ISSUE. Measure q hour and mark on canister
Air leak- seen w cont. tidaling in wtr seal chamber CALL MD
Assessment- asses pt resp status, vs, pain
Safety- keep canister below chest, don't pull on tubes.
Prevention of PE - ANSWERS• Passive, active ROM; ambulate soon after surgery
• Change position every 2 hours
• Anti-embolism stockings (SCD's)
• Avoid tight garters, girdles, constricting clothing
• No pillows under knees
• Comprehensive peripheral circulatory assessment
• Elevate affected limb 20 degrees above heart
• No massaging or compressing leg muscles
