NSG 2400 Pneumothorax & Chest tubes Test Questions and Correct Verified Solutions Version.

When a client suffers a complete pneumothorax, there is danger of a mediastinal shift. If such a shift occurs, what potential effect is a cause for concern? 1 Rupture of the pericardium 2 Infection of the subpleural lining 3 Decreased filling of the right side of the heart 4 Increased volume of the unaffected lung - Answer 3 Pressure within the pleural cavity causes a shift of the heart and great vessels to the unaffected side. This not only decreases the capacity of the unaffected lung but also impedes the filling of the right side of the heart and leads to a decreased cardiac output. Rupture of the pericardium might occur with severe chest trauma, not with a mediastinal shift. Infection is not caused by a mediastinal shift. The volume of the unaffected lung may decrease because of pressure from the shift. A client is diagnosed with a spontaneous pneumothorax. Which physiologic effect of a spontaneous pneumothorax should the nurse include in a teaching plan for the client? 1 Air will move from the lung into the pleural space. 2 The heart and great vessels shift toward the affected side. 3 There is greater negative pressure within the chest cavity. 4 Collapse of the other lung will occur if not treated immediately. - Answer 1 As a person with a tear in the lung inhales, air moves through that opening into the intrapleural space; this creates a positive pressure and causes partial or complete collapse of the lung. Mediastinal shift occurs toward the unaffected side. Greater negative pressure within the chest cavity is normal; with a pneumothorax, there is a loss of intrathoracic negative pressure. Collapse of the other lung will occur if not treated immediately is not an impending problem.