NSG 229 Exam 2 With Complete Solutions
Barotrauma - answers-Ventilation with positive pressure: pneumothorax or
subcutaneous emphysema
Monitor oxygenation status on chest x-ray
Assess for subcutaneous emphysema
Document all ventilator changes
High pressure ventilator alarm may indicate pneumothorax
Benzodiazepines - answers-Lorazepam & midazolam
Reduce anxiety and resistance to mechanical ventilator
Use caution in patients also using opioids
Blocked ETT - answers-Suction secretions, insert oral airway to prevent biting
tube, respond to high pressure alarms on ventilators
Blunt Trauma - answers-Striking or being struck by an object
Appears minor
,Chest Injuries - answers-Pulmonary contusion
Rib fracture
Flail chest
Pneumothorax
Hemothorax
Tracheobronchial trauma
Chest Trauma Assessment/Findings - answers-Respiratory: dyspnea, cough,
hemoptysis, tracheal deviation, diminished breath sounds, hypoxemia
Cardiac: rapid thready pulse, hypotension, muffled heart sounds, asymmetric
blood pressure, narrowed pulse pressure
Skin: bruising, abrasions, wound, hypoxia, cyanosis, asymmetric chest movement,
subcutaneous emphysema
Chest Trauma Initial Assessment - answers-Monitor & apply oxygen
SpO2 > 90%
IV access and fluid resuscitation
Remove clothing
Apply occlusive dressing
Stabilize impaled objects (DO NOT REMOVE)
, Needle decompression: midclavicular line, 2nd/3rd intercoastal space
Chest Tube Assessment - answers-Respiratory status, pain level, insertion site
drainage, patient drainage/suction tubing, wall suction 80-100 mmHg
Chest Tube Complications - answers-Bleeding
Infection
Malpositioning
Empyema
Recurrent pneumothorax
Tension pneumothorax
Subcutaneous emphysema
Blocked tube
Chest Tube Components - answers-Collection chamber, water-seal chamber,
suction control chamber
Chest Tube Management - answers-Change dressing according to policy
Monitor drainage per policy
Barotrauma - answers-Ventilation with positive pressure: pneumothorax or
subcutaneous emphysema
Monitor oxygenation status on chest x-ray
Assess for subcutaneous emphysema
Document all ventilator changes
High pressure ventilator alarm may indicate pneumothorax
Benzodiazepines - answers-Lorazepam & midazolam
Reduce anxiety and resistance to mechanical ventilator
Use caution in patients also using opioids
Blocked ETT - answers-Suction secretions, insert oral airway to prevent biting
tube, respond to high pressure alarms on ventilators
Blunt Trauma - answers-Striking or being struck by an object
Appears minor
,Chest Injuries - answers-Pulmonary contusion
Rib fracture
Flail chest
Pneumothorax
Hemothorax
Tracheobronchial trauma
Chest Trauma Assessment/Findings - answers-Respiratory: dyspnea, cough,
hemoptysis, tracheal deviation, diminished breath sounds, hypoxemia
Cardiac: rapid thready pulse, hypotension, muffled heart sounds, asymmetric
blood pressure, narrowed pulse pressure
Skin: bruising, abrasions, wound, hypoxia, cyanosis, asymmetric chest movement,
subcutaneous emphysema
Chest Trauma Initial Assessment - answers-Monitor & apply oxygen
SpO2 > 90%
IV access and fluid resuscitation
Remove clothing
Apply occlusive dressing
Stabilize impaled objects (DO NOT REMOVE)
, Needle decompression: midclavicular line, 2nd/3rd intercoastal space
Chest Tube Assessment - answers-Respiratory status, pain level, insertion site
drainage, patient drainage/suction tubing, wall suction 80-100 mmHg
Chest Tube Complications - answers-Bleeding
Infection
Malpositioning
Empyema
Recurrent pneumothorax
Tension pneumothorax
Subcutaneous emphysema
Blocked tube
Chest Tube Components - answers-Collection chamber, water-seal chamber,
suction control chamber
Chest Tube Management - answers-Change dressing according to policy
Monitor drainage per policy
