NUR 2755 | NUR2755 MULTIDIMENSIONAL
CARE IV (MDC 4) FINAL EXAM
STUDYGUIDE RATED A+ | LATEST
2024/2025
Pulmonary embolism clinical manifestations
-Tachycardia
-Increased respiratory rate
-Hypotension
-Crackles
-Sudden onset of dyspnea
-Sharp, stabbing chest pain
-Shortness of breath
-Apprehension, restlessness
-Cough/bloody sputum
-Tachycardia
-Petechiae over chest and axillae
Pulmonary embolism risk factors
-Prolonged immobility
-Central venous catheters
-Smoking
-Birth control/estrogen
-Musculoskeletal injuries (spinal cord)
-Atrial fibrillation!!!
-Surgery
-Pregnancy
-Obesity
-Advancing age
-Conditions that increase blood clotting
-History of PE/DVT
,Pulmonary embolism diagnostics
-Computed tomography pulmonary angiography (CTPA)
-Helical CT
-Elevated D-Dimer (Normal <0.4 mcg/mL)
Pulmonary embolism treatment
ANTICOAGULANTS
Heparin (monitor PTT/aPTT)
Warfarin (monitor PT and INR)
During transition period between heparin and warfarin, monitor aPTT, INR,
and platelet count
Pulmonary embolism surgical management
Embolectomy
The surgical or percutaneous removal of the embolus
IVC filtration (filter)
With placement of a retrievable vena cava filter prevents further emboli
from reaching the lungs in patient with ongoing risk for PE
Pulmonary edema clinical manifestations
Pink frothy sputum
Coarse crackles
Low pitched crackles
Pulmonary edema teaching
-Take meds and finish them
-Monitor for swelling of the face or SOB
-Daily weights and notify if you gain more than 2lb/day or 5lb/week
-LOW sodium diet
Early signs of pneumonia
Purulent sputum
Diminished lung sounds
Fatigue
Cough
,Late signs of pneumonia
Chest pain
Dyspnea
Tachycardia
Activity intolerance
Respiratory distress
Flail chest clinical manifestations
-KEY SYMPTOM: Paradoxical chest movement/respirations
Pattern of breathing in which the chest wall contracts during inspiration and
expands with expiration
-Dyspnea
-Cyanosis
-Tachycardia
-Hypotension
-The patient is often anxious, short of breath, and in pain
Flail chest treatment
-Intubate!
-Usually stabilized with positive-pressure ventilation
Tension pneumothorax
Life-threatening complication of pneumothorax in which air continues to
enter the pleural space during inspiration and does not exit during
expiration.
As a result, air collects under pressure, completely collapsing the lung and
compressing blood vessels, which limits blood return. This process leads to
decreased filling of the heart and reduced cardiac output.
Pneumothorax clinical manifestations
-KEY SYMPTOM: When severe, deviation of the trachea toward the
unaffected side
-Reduced chest movement on the affected side
-Reduced (or absent) breath sounds of the affected side
, Tension pneumothorax clinical manifestations
-Distended neck veins
-Tracheal deviation to the unaffected side
-Extreme respiratory distress and cyanosis
-Hemodynamic instability
Hemothorax clinical manifestations
Percussion on the involved side produces a dull sound
Pneumothorax treatment
Chest tube
Tension pneumothorax treatment
Immediate needle thoracostomy
Hemothorax treatment
-Thoracentesis
-Chest tube
Thoracentesis position
Sitting on the side of the bed and leaning over the table (during procedure);
Affected side up (after procedure)
Chest tube tidaling
Fluid will go up and down with respiratory effort (in water seal chamber)
Chest tube bubbling
-Okay to have occasional bubbles in water seal chamber on initial
insertion (means air is leaving)
-Continuous bubbling in the water seal chamber means there is a leak
Chest tube suction chamber
-Controls amount of suction in the client’s cavity
-Constant bubbling here is NORMAL
CARE IV (MDC 4) FINAL EXAM
STUDYGUIDE RATED A+ | LATEST
2024/2025
Pulmonary embolism clinical manifestations
-Tachycardia
-Increased respiratory rate
-Hypotension
-Crackles
-Sudden onset of dyspnea
-Sharp, stabbing chest pain
-Shortness of breath
-Apprehension, restlessness
-Cough/bloody sputum
-Tachycardia
-Petechiae over chest and axillae
Pulmonary embolism risk factors
-Prolonged immobility
-Central venous catheters
-Smoking
-Birth control/estrogen
-Musculoskeletal injuries (spinal cord)
-Atrial fibrillation!!!
-Surgery
-Pregnancy
-Obesity
-Advancing age
-Conditions that increase blood clotting
-History of PE/DVT
,Pulmonary embolism diagnostics
-Computed tomography pulmonary angiography (CTPA)
-Helical CT
-Elevated D-Dimer (Normal <0.4 mcg/mL)
Pulmonary embolism treatment
ANTICOAGULANTS
Heparin (monitor PTT/aPTT)
Warfarin (monitor PT and INR)
During transition period between heparin and warfarin, monitor aPTT, INR,
and platelet count
Pulmonary embolism surgical management
Embolectomy
The surgical or percutaneous removal of the embolus
IVC filtration (filter)
With placement of a retrievable vena cava filter prevents further emboli
from reaching the lungs in patient with ongoing risk for PE
Pulmonary edema clinical manifestations
Pink frothy sputum
Coarse crackles
Low pitched crackles
Pulmonary edema teaching
-Take meds and finish them
-Monitor for swelling of the face or SOB
-Daily weights and notify if you gain more than 2lb/day or 5lb/week
-LOW sodium diet
Early signs of pneumonia
Purulent sputum
Diminished lung sounds
Fatigue
Cough
,Late signs of pneumonia
Chest pain
Dyspnea
Tachycardia
Activity intolerance
Respiratory distress
Flail chest clinical manifestations
-KEY SYMPTOM: Paradoxical chest movement/respirations
Pattern of breathing in which the chest wall contracts during inspiration and
expands with expiration
-Dyspnea
-Cyanosis
-Tachycardia
-Hypotension
-The patient is often anxious, short of breath, and in pain
Flail chest treatment
-Intubate!
-Usually stabilized with positive-pressure ventilation
Tension pneumothorax
Life-threatening complication of pneumothorax in which air continues to
enter the pleural space during inspiration and does not exit during
expiration.
As a result, air collects under pressure, completely collapsing the lung and
compressing blood vessels, which limits blood return. This process leads to
decreased filling of the heart and reduced cardiac output.
Pneumothorax clinical manifestations
-KEY SYMPTOM: When severe, deviation of the trachea toward the
unaffected side
-Reduced chest movement on the affected side
-Reduced (or absent) breath sounds of the affected side
, Tension pneumothorax clinical manifestations
-Distended neck veins
-Tracheal deviation to the unaffected side
-Extreme respiratory distress and cyanosis
-Hemodynamic instability
Hemothorax clinical manifestations
Percussion on the involved side produces a dull sound
Pneumothorax treatment
Chest tube
Tension pneumothorax treatment
Immediate needle thoracostomy
Hemothorax treatment
-Thoracentesis
-Chest tube
Thoracentesis position
Sitting on the side of the bed and leaning over the table (during procedure);
Affected side up (after procedure)
Chest tube tidaling
Fluid will go up and down with respiratory effort (in water seal chamber)
Chest tube bubbling
-Okay to have occasional bubbles in water seal chamber on initial
insertion (means air is leaving)
-Continuous bubbling in the water seal chamber means there is a leak
Chest tube suction chamber
-Controls amount of suction in the client’s cavity
-Constant bubbling here is NORMAL
