Nursing Questions

Questions

1) In extreme cases, clinical manifestations of a pneumothorax can cause a bluish skin color due to lack of oxygen, chest tightness, quick fatigue, and a quick heartbeat. A pneumothorax, or collapsed lung, is normally caused by preexisting conditions such as asthma, COPD, cystic fibrosis, tuberculosis, and whooping cough or certain injuries to the chest area such as a gunshot wound or rib fracture. Tall and thin individuals also are more susceptible to pneumothorax.

2) The symptomatology of a pneumothorax is shortness of breath and a strong pain in the chest that becomes worse with deep breathing or coughing. In order to assess the issue, the nurse should inspect the chest area and look for unequal chest expansion; the affected side will not fully expand. If the voice and breathing sound faint, this could also signal a pneumothorax (Bauer, 2006). Diagnostic tests can include a blood test to measure the amount of oxygen in the blood as well as a chest x-ray. Treatment of a pneumothorax can range from home oxygen therapy, or inserting a needle or tube through the rib cage to relieve pressure to surgery in more extreme cases.

3) Chest tube drainage system maintenance requires the nurse to evaluate a number of processes every one to four hours: assess cardiopulmonary and vital signs, monitor fluid and record its consistency, monitor for pain and discomfort at the insertion site, and inspect the system for the bubbling or changes in the elevation in the water seal chamber. One must be prudent to verify connections. If the chest tube becomes disconnected from the drainage system, the nurse should clean the exposed area with an antiseptic and reconnect. When disconnected from the patient, apply an occlusive dressing over the area and contact the physician.

4) Subcutaneous emphysema occurs when air gets under the skin and enters surrounding tissues. To access it, the nurse should be aware that surgical drainage might be necessary if it is uncomfortable. Otherwise, this is normally a benign effect of a more severe malady.

Reference

Bauer, P. (2006, January 1). Pneumothorax: Assessment. RnCeus. Retrieved February 20, 2014, from http://www.rnceus.com/resp/pneumothor.html