Signs and Symptoms
This is air in the tissue and can sometimes be found around an open wound to the chest or a chest tube.
What is subcutaneous emphysema?
This is key patient and nursing priority for patients with a chest tube in place (after the ABCDE’s are managed).
What is pain management?
This is the usual cause of a spontaneous pneumothorax in an otherwise healthy individual.
What is the rupture of a bleb or bulla?
This is a diagnostic used to confirm a pneumothorax.
What is a chest x-ray?
This is what a chest tube helps to normalize in the pleural space.
What is negative pressure?
This is an expected finding when percussing over the lung field area of a pneumothorax
What is hyperresonance?
This is the best way to position a patient with a pneumothorax or a pleural effusion.
What is with the HOB 45 degrees (or sitting up with pillows to support)?
These are the top 2 common causes of a pleural effusion.
What is CHF, cancers and pneumonias?
This is a lab value that might indicate a pleural effusion is from a bacterial origin such as an empyema.
What is an elevated white blood cell count (or WBCs in the pleural fluid)?
This type of finding is seen when there is bubbling in the water seal chamber of a patient with a pleural effusion.
What is abnormal or concerning?
Seeing distended neck veins in a patient with a pneumothorax might indicate this.
What is a tension pneumothorax?
This is the rationale for using a diuretic when providing nursing care to a patient with a pleural effusion
What is to “treat the underlying cause” in a clinical case such as CHF?
In a ventilated patient, this is what can lead to an elevated risk of a pneumothorax?
What is too high positive end expiratory pressure (PEEP)?
This is an expected finding on the ABG of a patient with a significant pneumothorax.
What is a low PaO2?
This is how the amount of negative pressure exerted in the pleural space by a chest tube is controlled.
What is the dial on the pleur-evac system?
An anticipated abnormal finding in a patient with a pneumothorax may be this kind of chest wall movement.
What is asymmetrical?
These are assessment findings that prompt the nurse to worry about a patient with a DVT developing a PE.
What is SOB, chest pain, sense of doom, pallor etc...?
Pregnancy and birth can be a risk factor for this acute respiratory alteration.
What is a pulmonary embolism?
A negative D-dimer can help rule out this acute alteration.
What is a pulmonary embolism?
These are signs that a pneumothorax has resolved and the patient is ready for the chest tube to be removed.
What is less (or no) bubbling in the system, deeper lung expansion on auscultation etc...?
This finding is a strong indicator of a tension pneumothorax and indicates emergency intervention is needed.
What is tracheal deviation?
This is the nurse’s #1 priority to assess and intervene on first with any patient with respiratory alterations.
What is AIRWAY?
In a patient involved in a MVC, this injury should prompt the nurse to assess for signs of a pneumothorax.
What is rib fractures?
This is the diagnostic of choice for a pulmonary embolism.
What is a CT Scan?
In the case of a tension pneumothorax, these are signs that a rapid needle decompression and a chest tube insertion are improving the patient’s condition.
What is increased circulation (BP), less distention in neck veins, more lung expansion on affected side and air entry being heard etc...?