Term
|
Definition
| A collection of air in the pleural space. |
|
|
Term
| How is pneumothorax treated? |
|
Definition
| Needle aspiration and/or placement of a chest tube is used to evacuate the air from the chest. Some small pneumothoraces resolve independently without intervention |
|
|
Term
| What age group of CHILDREN are most affected by primary (spontaneous) pneumothorax? |
|
Definition
|
|
Term
| What will lung sounds sound like on the side effected by pneumothorax? |
|
Definition
|
|
Term
| When a person has a chest tube - What should be kept at bedside for use in the event the tube becomes dislodged from the drainage container? |
|
Definition
|
|
Term
| How often is the dressing around a chest tube routinely changed? |
|
Definition
| Dressing is occlusive - should not be routinely changed |
|
|
Term
| If a chest tube becomes dislodged from a chest - what should you do? |
|
Definition
| Apply vaseline gauze & occlusive dressing, perform respiratory assessment, notify MD |
|
|
Term
| What is the most commonly use type of mechanical ventilation? |
|
Definition
| Volume cyucled ventillator |
|
|
Term
| How do volume cycled ventilators work? |
|
Definition
Volume of air delivered with each inspiration is set. Once the volume of air is delivered to your patient the vent cycles off and exhalation occurs passively
i.e.
Machine pushes air into lungs
Machine shuts off
Patient breaths out passively |
|
|
Term
| How would a patient with anxiety r/t difficulty breathing & strange equipment be treated? |
|
Definition
|
|
Term
| Do patients with ET or Trach tubes have difficulty with communication? |
|
Definition
| YES. Verbal communicaiton impaired |
|
|
Term
| How would a patient on a mechanical vent with ABGs showing respiratory acidosis be treated? |
|
Definition
| Vent rate would be increased |
|
|
Term
| Why is it important to monitor O2 sats and ABGs for a patient on a mechanical ventillator? |
|
Definition
| These assessment values affect the settings the vent should be on |
|
|
Term
| What is the primary concern with emesis for a patient on a vent? |
|
Definition
|
|
Term
| 9 important ongoing assessments for patients on mechanical ventillators |
|
Definition
LOC
Vital Signs
Lung Assessments
02 Sats & ABGs
Signs of decompensation
Assess oral mucous membranes
Monitor pulmonary secretions
Assess for gastric distention |
|
|
Term
| Why is it important to monitor for gastric distention on a patient with a mechanical vent? |
|
Definition
| because gastric distention can lead to emesis which can lead to aspiration which leads to aspiration pneumonia |
|
|
Term
| What do changes in LOC signify for a patient on a mechanical vent? |
|
Definition
|
|
Term
| What is important for the nurse to know in case the ventilator becomes inoperable? |
|
Definition
| the patient's ability to breathe spontaneously |
|
|
Term
| What should be done if a ventilator beccomes inoperable? |
|
Definition
| Ambu bag with mask connected to 02 at the bedside |
|
|
Term
| When is it okay to turn alarms off on mechanical vents? |
|
Definition
|
|
Term
| What equipment should be present at the bedside for a patient on a vent? |
|
Definition
suction equipment
Ambu bag with mask connected to 02 |
|
|
Term
| What alarm would go off if a patient has an accumulation of bronchial secretions? |
|
Definition
|
|
Term
| What alarm would go off if a vent hose became disconnected from a patient>? |
|
Definition
|
|
Term
|
Definition
| Ventalator associated pneumonia |
|
|
Term
| What can be used to decrease risk for VAP? |
|
Definition
| continuous subglottic suction for secretions |
|
|
Term
| What special oral hygiene methods can be used to decrease risk for VAP? |
|
Definition
| Q2 hrs w/ antibiotic solution |
|
|
Term
| Should H2 blockers & PPI be used for all vent patients? |
|
Definition
|
|
Term
| What is a "sedative vacation?" |
|
Definition
| Patients should be taken off sedation for 6-8 hours per day. |
|
|
Term
| How soon should patients be extubated? |
|
Definition
|
|
Term
| What angle should the HOB be kept at for patients on mechanical vents? |
|
Definition
| 35-45 degrees, help prevent VAP & pooling of secretions. |
|
|
Term
| What is the decision to wean a patient from a ventilator based on? |
|
Definition
| patients respiratory, cardiac, level of fatigue, and psychological status' |
|
|
Term
| What would a "T piece" be used for? |
|
Definition
| Weaning a patient with a trach from mechnical ventilation |
|
|
Term
|
Definition
Synchronized intermittent mandatory ventilation
The vent gets synchronized to the patient. |
|
|
Term
|
Definition
| Pressure support ventilation |
|
|
Term
|
Definition
| Continuous positive airway pressure |
|
|
Term
|
Definition
Acute Respiratory Distress Syndrome
Sudden & progressive form of acute respiratory failure in which alveolar capillary membrane becomes damaged & more permeable to IVF (intravascular fluid) |
|
|
Term
| What causes/triggers ARDS? |
|
Definition
Sepsis
Aspiration
Trauma to lung tissue
Shock |
|
|
Term
| What is the connection between ARDS and the heart? |
|
Definition
Not related.
Non-Cardiac pulmonary edema |
|
|
Term
| What happens to the alveoli with ARDS? |
|
Definition
They collapse.
Deccreased surfactant activity |
|
|
Term
| What happens to the alveolar interstitial spaces with ARDS? |
|
Definition
| fluid leaks into the alveolar interstitial spaces |
|
|
Term
| is ARDS rapid or gradual onset? |
|
Definition
|
|
Term
| Do patients with ARDS have difficulty breathing? |
|
Definition
| Yes, severe rapid onset dyspnea |
|
|
Term
| How much 02 is usually needed to increase 02 sats in a patient with ARDS? |
|
Definition
| No matter how much 02 you gie them, you can't get the sats to come up |
|
|
Term
| What does the chest x ray of an ARDS patient show? |
|
Definition
Non-cardiac bilateral pulmonary edema
Dense pulmonary infiltrates |
|
|
Term
| What often accompanies ARDS? |
|
Definition
|
|
Term
| What are early signs and symptoms of ARDS? |
|
Definition
increasing dyspnea
nasal flaring, restless, apprehensive, dyspnea, tachypnea, moderate use of accessory muscles
MAY have clear breath sounds (no crackles in beginnin) |
|
|
Term
| What are signs & symptoms of ARDS beyond the early stage |
|
Definition
Refractory hypoxia
Increased respiratory distress
Fine Crackles
Agitation
Respiratory acidosis
Diffuse bilat lung infiltrates |
|
|
Term
|
Definition
By treating the underlying cause.
ET intubatino (PEEP)
Mechanical vent
Fluid management
Prone position
Treat sepsis w/ antibiotics |
|
|
Term
| What position might a patient with ARDS be put in? |
|
Definition
|
|
Term
| Should patients with ARDS cough? |
|
Definition
| Yes. Encourage frequent coughing |
|
|
Term
| What should be done to a mechanically ventilated patient before suctioning? |
|
Definition
|
|
Term
| How long should suctioning take? |
|
Definition
|
|
Term
| When can PEEP be interrupted? |
|
Definition
|
|
Term
| What should be done with nutrition for patients with ARDS? |
|
Definition
|
|
Term
| Is there much concern with fluids for patients with ARDS? |
|
Definition
|
|
Term
| What is the eventual outcome of people with ARDS? |
|
Definition
| If they live - will likely have permanant pulmonary issues |
|
|
Term
| Should patients with ARDS be turned? |
|
Definition
|
|
Term
Define
Tital volume
(What is normal?) |
|
Definition
| The amount of air moved in and out with each breath. For individuals of average build the tidal volume can range between 500 and 1000ml |
|
|
Term
Define
Respiratory Rate
(in reference to mechanically ventillated patients) |
|
Definition
| The number of breaths the vent is programmed to delivery per minute. Usually 10-14 breaths per minute. Higher or lower rates may be necessary in some patients depending on their specific condition |
|
|
Term
| Inspiratory/expiratory ratio |
|
Definition
| During normal breathing, the expiratory phase lasts as long as the inspiratory phase to allow for emptying of the lungs. This ratio is usually set at 2:1 (expiration:inspiration) to approximate normal physiological function |
|
|
Term
|
Definition
| The speed with which the vent is programmed to deliver the tidal volume |
|
|
Term
|
Definition
| The fraction of inspired oxygen (FiO2) to be delivered This percentage can vary from room air (21%) to 100% |
|
|
Term
| What can happen when higher percentages (Greater than 50%) of oxygen are given for prolonged periods of time? |
|
Definition
| Alveolar damage from oxygen toxicity |
|
|
Term
| What settings should the vent have for delivery of FiO2? |
|
Definition
| The vent should be set to deliver the lowest FiO2 that keeps your patient's sat =/> 90% or his/her PaO2 above 60% |
|
|
Term
|
Definition
| Normally, an individual signs or takes a deep breath periodically. A mechanism for sighing can be proved by the vent. |
|
|
Term
| What is the value of "signs" |
|
Definition
| Sighing prevents atelectasis by causing hyperinflation of the lungs |
|
|
Term
|
Definition
| Lung collapse caused by a blockage of the airways |
|
|
Term
|
Definition
| The maximum amount of force allowed to deliver a specific volume of air into the lungs |
|
|
Term
| Why do vents need pressure limit settings? |
|
Definition
| Damage to the lungs may result from the use of high pressure to deliver the tidal volume. |
|
|
Term
| What does a low-pressure alarm on a mechanical vent signify? |
|
Definition
| an air leak within the patient or inside the ventilator. |
|
|
Term
| Where would a leak in a patient causing a low pressure alarm happen? |
|
Definition
| Leakage of air around the cuff of the ET or Trach tube, or from a persistant air leak after thoracic surgery |
|
|
Term
| Where would a leak in a ventilator occur causing a low pressure alarm? |
|
Definition
| disconnection of the ventilator tubing. |
|
|
Term
| When will a high-pressure alarm sound? |
|
Definition
| Whenever the pressure volume is reached, but the full delivery of tidal volume did not occor. |
|
|
Term
| What alarm would sound if there was an obstruciton of inspiratory tubing caused by kinks? |
|
Definition
|
|
Term
| What alarm would sound if there was condensation of water? |
|
Definition
|
|
Term
| What alarm wound sound if the patient's body weight was lying on the tubing? |
|
Definition
|
|
Term
| What alarm would sound if the airway was obstructed by herniation of the cuffr over the end of the ET or trach tube? |
|
Definition
|
|
Term
| What alarm wound sound if the aptient was biting the ET tube or pinching the tubing and preventing the inflow of air? |
|
Definition
|
|
Term
| What alarm wound sound if there was a significant accumulation of bronchial secretions? |
|
Definition
|
|
Term
| What would coughing during the inspiratory cycle of ventilation trigger? |
|
Definition
|
|
Term
|
Definition
| The large bellows like container on the ventilator that measures the volume of air the patienet expires |
|
|
Term
| What is the function of the spirometer alarm? |
|
Definition
| This alarm sounds when the volume of air exhaled is less than the amount set on the meter. Occasionally, the bellows may stick, causing the alarm to sound. The underlying reason can be identified by noting whether the problem is related to the high pressure or the low-pressure alarm. |
|
|
Term
Volume cycled ventilator
Control Mode |
|
Definition
Essentially controls your patient's breathing
This is for when they can't breathe on their own.
Pre-set volume delivered regardless of patient's attempts to breathe. |
|
|
Term
Volume cycled ventilator
Assist Control Mode |
|
Definition
Ventilator will deliver a pre-set volume of air at the prescribed rate in response to your patient's inspiratory efforts.
The vent will also initiate a breath if the patient fails to do so within a pre-set time
This is for spontaneously breathing patients with weak respiratory muscles |
|
|
Term
Volume cycled ventilator
Synchronized intermittent mandatory ventilation
(SIMV) |
|
Definition
Delivers a preset tidal volume or pressure and rate while allowing your patient to spontaneously breathe in between ventilator breaths
Ventilator breaths are synchronized with patient's respiratory effort
-Weaning from Vent
-Prevent resp. muscle fatigue |
|
|
Term
| Positive end-expiratory pressure: PEEP |
|
Definition
The PEEP option allows a preset amount of pressure to remain in the alveoli between the end of one breath and the beginning of another
Purpose: keep alveoli inflated between breaths (enhanses air exchange)
May cause decreased cardiac output (d/t higher chest pressure), trauma to alveoli, and increased ICP |
|
|
Term
| Pressure support ventilation (PSV) |
|
Definition
Patient breathes spontaneously, but ventilator proveds a present level of pressure assist with each spontaneous breath (inspiration only)
Patient controls rate, inspiratory flow, and tidal volume |
|
|
Term
| Continuous positive airway pressure (CPAP) |
|
Definition
May be used with invasive as well as non-invasive methods.
This option simply provides continuous baseline pressure without delivering a preset volume of air. The vent applies positive pressure during spontaneous breaths, improving oxygenation by keeping alveoli open at the end of each expiration |
|
|
Term
| Bi-Level positive airway pressure: BiPAP |
|
Definition
Provides high and low positive end-expiratory pressure
Used with patients with acute or chronic respiratory failure, acute pulmonary edema, exacerbatinos of chronic obstructive pulmonary disease. Chronic heart failure, obstructive sleep apnea
Controls both inspiration & Expiration |
|
|
Term
| What mode would the volume cycled ventilator be on for a patient who can't breathe on their own? |
|
Definition
|
|
Term
| What volume cycled ventilator mode helps spontaneously breathing patients who have weak muscles? |
|
Definition
|
|
Term
| What volume cycled ventilator mode would help a patient prevent respiratory fatigue while weaning from the vent? |
|
Definition
Synchronized Intermittent Mandatory Ventilation
(SIMV) |
|
|
Term
| What type of setting on a volume cycled ventilator has the potential to decrease cardiac output, cause trauma to alveoli, and increase ICP? |
|
Definition
Positive end-expiratory pressure
(PEEP) |
|
|
Term
What type of ventilation provides a preset level of pressure assist with each spontaneous breath (inspiration only) to help patient take a better breath?
Who controls the rate, inspiratory flow, and tidal volume? |
|
Definition
Pressure support ventilation (PSV)
Patient controls rate, inspiratory flow, and tidal volume. |
|
|
Term
| What phase of breathing does BiPAP control? |
|
Definition
| Both inspiration & expiration |
|
|
Term
| Overall 5 year survival rate for lung cancer patients |
|
Definition
|
|
Term
| What is the treatment of lung cancer most often aimed at? |
|
Definition
| Palliation (relieving symptoms) |
|
|
Term
| Where do most primary lung cancers arise? |
|
Definition
|
|
Term
| Define bronchogenic carcinomas |
|
Definition
| lung cancers taht arise from the bronchial epithelium |
|
|
Term
| How can lung cancer spread? |
|
Definition
Direct extension
Through the blood
Invading lymph glands and vessels |
|
|
Term
| Where does lung cancer spread? |
|
Definition
| bone, liver, brain, adrenal glands |
|
|
Term
| Which type of lung cancer is most closely associated with paraneoplastic syndrome? |
|
Definition
|
|
Term
| paraneoplastic syndrome with ACTH would have what manifestation? |
|
Definition
|
|
Term
| paraneoplastic syndrome with antidiuretic hormone would have what manifestation? |
|
Definition
Syndrom of inappropriate antidiruetic hormone (SIADH)
Weight Gain
General edema
Dilution of serum electrolytes |
|
|
Term
| paraneoplastic syndrome with FSH would have what manifestation? |
|
Definition
|
|
Term
| paraneoplastic syndrome with parathyroid hormone would have what manifestation |
|
Definition
|
|
Term
| paraneoplastic syndrome with ectonic insulin would have what manifestation |
|
Definition
|
|
Term
| Non-smoking risk factors for lung cancer |
|
Definition
chronic exposure to:
asbestos,
beryllium
chromium
Coal,
cobalt
Iron oxide
mustard gas
petroleum distallates
radiation
tar
nickel
uranium |
|
|
Term
| What is primary prevention for lung cancer? |
|
Definition
| reducing tobacco smoking & environmental respiratory safety (such as specialized masks and protective clothing) |
|
|
Term
| What is secondary prevention for lung cancer? |
|
Definition
| Not feasible to detect lung cancers early, however annual CT scans are emerging as an option to detect stage 1 cancers |
|
|
Term
| What does pain radiating in the arm for a lung cancer patient indicate? |
|
Definition
| invasion of nerve plexuses in advanced disease |
|
|
Term
|
Definition
| areas of the lung where are spaces are replaced with fluid or tumor where sound is transmitted differently upon auscultation |
|
|
Term
| What does a trachea displacement from midline indicate for a lung cancer patient? |
|
Definition
| a mass present in the area |
|
|
Term
| When would a pleural friction rub be heard in a lung cancer patient? |
|
Definition
| When inflammation is present |
|
|
Term
| What is cardiac tamponade? |
|
Definition
| Heart sounds muffled by a tumor or fluid around the heart |
|
|
Term
| Why would dysrhythmias occur with lung cancer? |
|
Definition
| hypoxemia or direct pressure of the tumor on the heart` |
|
|
Term
| Superior vena cava syndrome |
|
Definition
| blockage or pressure on the superior vena cava preventing adequate blood return. Medical emergency. |
|
|
Term
| What psychosocial assessments are important for lung cancer patients |
|
Definition
Dyspnea and pain add to fear and anxiety
Patient with cig smoking history may feel guilt and shame
Convey acceptance, interact with patient in non-judgemental way
Encourage the patient and family to express feelings
Fear of pain and death |
|
|
Term
| How is lung cancer diagnosed? |
|
Definition
Biopsy.
Cytologic testing of early-mornign sputum specimines may identify tumor cells, however cancer cells may not be present in the sputum. When pleural effusion is present, fluid is obtained by thoracentesis for cystology. |
|
|
Term
| What type of imagining helps determine loation of metastatic tumors for lung cancer patients? |
|
Definition
| MRI & radionuclide scans of liver, spleen, brain, and bone. PET Scans |
|
|
Term
| How soon after chemo ends does hair growth begin again? |
|
Definition
|
|
Term
| What is important patient teaching in reference to immunosupression related to chemotherapy? |
|
Definition
| Teach patient and family about precautions to take to reduce the patient's chances of developing an infection |
|
|
Term
| What stage lung cancers are most often treated by targeted therapy? |
|
Definition
|
|
Term
| What is the normal treatment schedule for radiation to treat lung cancer? |
|
Definition
| Daily for a 5-6 week period |
|
|
Term
| What to tell patients who have esophagitis during radiation therapy for lung cancer |
|
Definition
| eat foods that are soft, bland, and high in calories. Suggest liquid nutrition supplements. |
|
|
Term
| How long after raidation therapy is the skin hypersensitive to light |
|
Definition
|
|
Term
| When might PDT be used for treatment of lung cancer? |
|
Definition
| For small bronchial tumors that are accessible by bronchoscopy |
|
|
Term
| In PDT - how long after injection of light-sensitizing agent has most of the agent collected in cancer cells? |
|
Definition
|
|
Term
| What type of sedation is used for the laser light part of PDT? |
|
Definition
|
|
Term
| Why would a patient be in ICU after laser light treatment with PDT? |
|
Definition
| Sloughing tissue and edema from inflammatory response can block airway. Also at risk for bronchial hemorrhage, fistula formation, and hemoptysis |
|
|
Term
| How long after PDT treatment do patients remain super-sensitive to light? |
|
Definition
| 30 to 90 days. Patients need special environmental manipulation to stay safe during hospital stay and for the next 3 months |
|
|
Term
What is the main treatment for stage 1 and stage 2 NSCLC?
What is the goal? |
|
Definition
Surgery for total removal of primary lung cancer
Goal is cure |
|
|
Term
|
Definition
| Removal of an entire lung |
|
|
Term
| What are the goals of preoperative care for patients undergoing surgery for lung cancer? |
|
Definition
Relieve anxiety
promote patient participation
Encourage patient to express fears and concerns
Reinforce surgeon's explination of procedure
Provide education for post-op
Teach about location of incision or openings, shoulder exersizes, and the chest tube and drainage system |
|
|
Term
How many incisions will be made in VATS?
What will they be used for post surgery? |
|
Definition
Three
used for placement of drains and chest tubes post surgery |
|
|
Term
| Who requires closed-chest drainage to drain air and blood that accumulate in the pleural space? |
|
Definition
| Patients who have undergone thoracotomy Except pneumonectomy |
|
|
Term
| What is the purpose of a chest tube? |
|
Definition
A drain placed in the pleural space to restore intrapleural pressure and allowing for re-expansion of the lung
Also prevents air and fluid from returning to the chest |
|
|
Term
| What is the nursing care priority for a patient with a chest tube? |
|
Definition
| ensure the integrity of the system, promote comfort, ensure chest tube patency, and prevent complications |
|
|
Term
| where is the tube used to drain air placed? |
|
Definition
|
|
Term
| Where is teh tube used to drain liquid placed? |
|
Definition
| on the side near the base of the lung |
|
|
Term
| How are puncture wounds around chest tubes dressed? |
|
Definition
|
|
Term
| How much tubing is connected to the chest tube and where does it connect to? |
|
Definition
| 6 ft. Connects to collection device BELOW the chest level by several feet |
|
|
Term
| What type of seal mechanism do stationary chest tube drainage systems usually use? |
|
Definition
|
|
Term
| What kidn of system is the "Pleur-evac" system? |
|
Definition
| One piece disposable plastic unit with three chambers. water seal. |
|
|
Term
| What is important when assessing the fullness of chamber one for a tube drainage system. Why? |
|
Definition
| The fluid in chamber one must NEVER fill to the point that it comes in contact with either the tube draining from the patient or the tube connecting this chamber to chamber 2. This could cause tension pneumothorax |
|
|
Term
| How much water should be in chamber 2 of a water seal chest tube drainage system? |
|
Definition
| 2cm - go by manufacturer's specifications |
|
|
Term
| When does bubbling happen in chamber 2 of a water seal chest tube drainage system? |
|
Definition
| When trapped air from the patient's pleural space passes through the water seal. Happens when introthoracic pressure is greater than atmospheric pressure, such as exhalation, coughing, or sneezing |
|
|
Term
| What kind of liquid is used in a chest tube draiange system with a water seal? |
|
Definition
|
|
Term
| What does excessive bubbling in the water seal chamber indicate? |
|
Definition
|
|
Term
| What does complete absennce of bubbling in chamber 2 indicate? |
|
Definition
| Either all air in the pleural space has been removed, or the tube is blocked or kinked |
|
|
Term
What is tidaling in a chest tube drainage system?
What would an absence of tidaling indicate? |
|
Definition
The water in the narrow column water seal chamber normally rises 2 to 4 inches during inhalation and falls during exhalation
An absence would indicate that the lung has fully re-expanded or that there is an obstruction in the chest tube |
|
|
Term
| What is chamber 3 in a chest tube drainage system? |
|
Definition
|
|
Term
|
Definition
| The fluid level in chamber three is prescribed by the healthcare provider. The chamber is connected to wall suction which is turned up until there is gentle bubbling in the chamber |
|
|
Term
|
Definition
| The health care provider prescribes the suction level to be dialed in on the device. When connected to wall suction, the regulator is set to the amount indicated by the device's manufacturer |
|
|
Term
| What is the level of suction determined by for chest tube drainage systems? |
|
Definition
| The chest tube drainage device - not the wall suction that it is connected to |
|
|
Term
| How often should patients with chest tube drainage systems be checked on? What are you checking for? |
|
Definition
Hourly.
Ensure sterility and patency of any chest drainage system. |
|
|
Term
| What can be done to prevent accidental disconnections with chest tubes? |
|
Definition
|
|
Term
| What should be kept bedside for use if the drainage system becomes disconnected? |
|
Definition
| padded clamps, sterile gauze |
|
|
Term
| How much should the chest tube be maniuplated? |
|
Definition
|
|
Term
| How often should the chest tube be stripped? |
|
Definition
| Never. This can create negative pressure and damage lung tissue |
|
|
Term
| If manipulation of a chest tube is unavoidable, what technique should be used? |
|
Definition
| gentle hand over hadn "milking" with stopping between each handhold. Used to move blood clots and prevent obstruction. follow agency policies. |
|
|
Term
| how often should respiratory status and amount/type of drainage be assessed and documented for the person with a chest tube? |
|
Definition
|
|
Term
How often during the first 24 hours is the drainage container emptied for patients with a chest tube?
After the first 24 hours? |
|
Definition
Only if the container is so full that it is in danger of coming into contact with the chest drainage tube
After first 24 hours - every 8 hours |
|
|
Term
| What amount of drainage from a chest tube would warrant a call to the MD? |
|
Definition
|
|
Term
| What test can be done to find out the origin of a leak in a chest tube drainage system? |
|
Definition
| Momentarily clamp the tube.If bubbling stops, the leak is at the patient, if bubbling continues, leak is between the clamp and the system |
|
|
Term
| What are "dry" chest tube drainage systems |
|
Definition
| Use a flutter valve to prevent backflow of air |
|
|
Term
| What kind of systems are portable light weight chest tube drainage systems? |
|
Definition
|
|
Term
| How to treat a patient with a chest tube who reports "burning" sensation in the chest? |
|
Definition
|
|
Term
| When samples of chest drainage are needed - where is the sample collected from? |
|
Definition
| From the chest tube. After clensing the chest tube, use a 20 gauge or smaller needle to draw up the specimin into the syringe |
|
|
Term
| What would be the appropriate response to a tracheal deviation for a patient with a chest tube |
|
Definition
| Notify the MD or rapid response team |
|
|
Term
| What would be the appropriate response to sudden onset or increased intensity of dyspnea in a patient with a chest tube? |
|
Definition
| Notify MD or rapid response team |
|
|
Term
| What should be done for an O2 sat less than 90% when a patient has a chest tube? |
|
Definition
| Notify MD or rapid response team |
|
|
Term
| What should be done for a drainage greater than 70ml/hr froma chest tube? |
|
Definition
| Notify MD or rapid response team |
|
|
Term
| What should be done for visible eyelets on chest tube? |
|
Definition
| Notify MD or rapid repsonse team |
|
|
Term
| What to do if chest tube disconnects from drainage system? |
|
Definition
| First put the end of tube in a container of sterile water below the level of the patient's chest, then notify MD or rapid response team. |
|
|
Term
| What shoudl be done if the drainage from a chest tube stops within the first 24 hours? |
|
Definition
|
|
Term
| What pain level is associated with open thractomy? |
|
Definition
|
|
Term
| When should patients use PCA when recovering from lung surgery |
|
Definition
| patients should be taught to use the PCA before pain becomes too severe |
|
|
Term
| Why is pain control so important after lung surgery? |
|
Definition
| Because pain control is vital in allowing patients to participate in techniques that reduce the risk for postoperative complications |
|
|
Term
| What should be monitored before and after opioid analgesic administration? |
|
Definition
| Vital signs, especially for a patient who is not mechanically ventilated. |
|
|
Term
| When should care activities be performed on a patient post-lung surgery? |
|
Definition
| Time activities with analgesia to reduce stimulation of additional pain |
|
|
Term
| How is the patient breathing immediately after a lung surgery? |
|
Definition
| Usually mechanically ventilated |
|
|
Term
| What are nursing priorities after the patient is breathing on his own? |
|
Definition
| Maintain a patant airway, esure adequate ventilation, prevent complications. |
|
|
Term
| How often should a patient be assessed once they are breathing on their own? |
|
Definition
|
|
Term
| What sound is particularly important to listen for a patient post lung surgery? |
|
Definition
| Crackles on the nonoperative side |
|
|
Term
| What kind of oxygen does the post op lung surgery patient get? for how long? |
|
Definition
| Warm humidified oxygen via mask or nasal cannula for 2 days after surgery |
|
|
Term
| How often should insentive spirometer be used while awake post op lung infection? |
|
Definition
|
|
Term
| What position is good to get a patient into as soon as possible after lung surgery? |
|
Definition
| semi-Fowler's or up into a chair |
|
|
Term
| What helps prevent mediastinal shift towards the affected side post pneumonectomy? what is not used? |
|
Definition
A clamed chest tube to help serous fluid accumulate and create adhesions.
Closed chest drainage is usually not used |
|
|
Term
| What side shoudl the patient be positioned on post pneumonectomy? |
|
Definition
| Per surgeon order. Everybody's got an opinion. Non operative side reduces stress on bracheal stump, operative side allows fluids to fill up the space. |
|
|
Term
| Complications of pneumonectomy |
|
Definition
|
|
Term
| what is prescribed for dyspnea and anxiety for a patient for palliative care, even if they are not hypoxic? |
|
Definition
|
|
Term
| What kinds of drugs are prescibed for a patient with a bronchospasm? |
|
Definition
| Bronchodilators and corticosteroids |
|
|
Term
| How is superior vena cava syndrome treated? |
|
Definition
|
|
Term
| What is the schedule for radiation therapy used for palliation? |
|
Definition
| Higher doses shorter periods |
|
|
Term
| What is used to treat plerual effusion for a patient receivign palliation for lung cancer? |
|
Definition
| Thoracentesis. Possible to insert continuously draining catheter if fluid rapidly re-forms |
|
|
Term
| What position is usually most comfortable for a patient with dyspnea d/t lung cancer? |
|
Definition
| semi-fowlers or a reclining chair |
|
|
Term
| What is acute respiratory failure classified by? |
|
Definition
| blood glas abnormalities. The critical values are PaO2 less than 60 Oxygen saturation less than 90%, or PaCO2 greater than 50 occuring with pH less than 7.3 |
|
|
Term
| What are the classes of respiratory failure? |
|
Definition
Ventilatory failure
oxygenation failure
Combination of ventilatory and oxygenation failure |
|
|
Term
|
Definition
| low arterial blood oxygen levels |
|
|
Term
| What is ventilatory failure? |
|
Definition
| problem with oxygen intake and blood delivery that causes a ventilation-perfusion (V/Q) mismatch in which perfusion is normal but ventilation is inadequate. It occurs when the chest pressure does nto change neough to permit air movement into and out of the lungs. too little oxygen reaches the alveoli and carbon dioxide is retained |
|
|
Term
| what is it called when the chest pressure does not change enough to permit air movement into and out of the lungs? |
|
Definition
|
|
Term
| What does inadequate oxygen intake or carbon dioxide retention lead to? |
|
Definition
|
|
Term
| What problems cause ventilatory failure? |
|
Definition
physical problem of the lungs or chest wall
defect in respiratory control center of the brain
poor function of respiratory muscles (especially diaphram) |
|
|
Term
| How are causes of ventilatory failure classified? |
|
Definition
extrapulmonary (involving non-pulmonary tissues
intrapulmonary (issues of the respiratory tract) |
|
|
Term
| What is oxygenation failure? |
|
Definition
Air movement and oxygen intake are normal
Lung blood flow (perfusion) is decreased |
|
|
Term
| What situations cause oxygenation failure? |
|
Definition
Impaired diffusion of oxygen at the alveolar level
Right to left shunting of blood in pulmonary vessels
Breathing air with a low oxygen level
abnormal hemoglobin that fials to bind oxygen. |
|
|
Term
| What would happen if 100% oxygen is given to patient who has blood shunted to the left side of the heart? |
|
Definition
|
|
Term
| What is a classic cause of V/Q mismatch |
|
Definition
| ARDS Acute respiratory distress syndrome |
|
|
Term
| When is dyspnea most intense? |
|
Definition
|
|
Term
| When would slowly progressive respiratory failure first be noticed? |
|
Definition
| Dyspnea on exertion or when lying down |
|
|
Term
|
Definition
| easier to breathe in an upright position |
|
|
Term
| With chronic respiratory problems what would a minor increase in dyspnea signify? |
|
Definition
| Severe gas exchange problems |
|
|
Term
|
Definition
| High arterial blood levels of carbon dioxide |
|
|
Term
| Who is oxygen therapy appropriate for? |
|
Definition
| any patient with acute hypoxemia |
|
|
Term
| What is tha PaO2 goal level when treating a patient with oxygen while treating the cause of respiratory failure? |
|
Definition
|
|
Term
| What is done if oxygen therapy does not maintain acceptable PaO2 levels ? |
|
Definition
|
|
Term
| What are the features of ARDS? |
|
Definition
hypoxemia that persists even with 100% oxygen
decreased pulmonary compliance
dyspnea
Noncardiac associated bilateral pulmonary edema
Dense pulmonary ifiltrates on x-ray (ground-glass appearance) |
|
|
Term
| What are other terms for ARDS? |
|
Definition
adult respiratory distress
Shock lung |
|
|
Term
| When does ARDS often occur in patients with no pulmonary disease? |
|
Definition
| patients with no pulmonary disease after a traumatic event |
|
|
Term
| What is the fundemental problem with ARDS? |
|
Definition
Systemic inflammatory response.
Alveolar-capillary membrane injury makes membrane more permiable. Allows debris, proteins, and fluid into the alveoli. |
|
|
Term
|
Definition
| Transfusion-related acute lung injury. Non cardiogenic pulmonary edema associated with activation of inflammatory response due to recent transfusion of plasma containing products. |
|
|
Term
| What can all problems that cause cerebral hypoxia lead to? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| disseminated intravascular coagulation |
|
|
Term
| What is the nursing priority in the prevention of ARDS? |
|
Definition
| Early recognition of patients at high risk. |
|
|
Term
| Who is at high risk for ARDS? |
|
Definition
| Patients receiving tube feedings and those with problems that impair swallowing and gag reflexes |
|
|
Term
| Where does edema occur first in ARDS? |
|
Definition
| interstitial spaces not the airways - so you won't hear it right away. |
|
|
Term
| What should be assessed hourly for patients at high risk of ARDS? |
|
Definition
| Vital signs, hypotension, tachycardia, dysrhythmias |
|
|
Term
|
Definition
| lowerd partial pressure of arterial oxygen (PaO2) value, determined by ABGs |
|
|
Term
| Define refractory hypoxemia |
|
Definition
| Patient does not respond to higher concentratiosn of oxygen. Often needs intubation and mechanical ventillation |
|
|
Term
| What does a large difference between the predicted and actual alveolar oxygen tension indicate? |
|
Definition
|
|
Term
| What does a "ground glass" look on X ray indicate? |
|
Definition
|
|
Term
| What will an ECG show for a patietn with ARDS? |
|
Definition
|
|
Term
|
Definition
| Positive end expiraotry pressure. |
|
|
Term
| What is used to decrease tissue oxygen needs for patients with ARDS? |
|
Definition
|
|
Term
| What is one side effect of PEEP? |
|
Definition
|
|
Term
| What position might be used for a patient with ARDS? |
|
Definition
|
|
Term
| Why are corticosteroids used to manage ARDS? |
|
Definition
| They decrease white blood cell movement. Reduce inflammation, and stabalize capillary membranes. |
|
|
Term
| Should patients with ARDS be given conservitive or liberal fluid therapy? |
|
Definition
|
|
Term
| When is tube feeding initiated for a patient with ARDS? |
|
Definition
|
|
Term
| Management of Phase 1 ARDS |
|
Definition
| Support patient provide oxygen |
|
|
Term
| Management of Phase 2 ARDS |
|
Definition
| Mechanical ventilation prevention of complications |
|
|
Term
| Management of Phase 3 ARDS |
|
Definition
Usually days 2-10. Increasing hypoxemia that responds poorly to high levels of oxygen
Delivery adequate oxygen
Prevent complications
Support the lungs |
|
|
Term
| Management of Phase 4 ARDS |
|
Definition
Pulmonary fibrosis. Usually occurs after 10 days.
Often called "late" or "chronic" ARDS. Irreversable.
If a patient survives this stage they will likely have permanent lung damage.
Prevent sepsis pneumonia and multiple organ dysfunction syndrome.
Wean patient from ventilator. |
|
|
Term
| What patients might need lifelong mechnical ventilation? |
|
Definition
| severe restrictive lung disease or chronic progressive neuromuscular disease that reduces ventilation |
|
|
Term
| Who is mechanical ventilation most often used for? |
|
Definition
patients with hypoxemia and progressive alveolar hypoventilation with respiratory acidosis
After surgery
General anesthesia or heavy sedation
patient too exausted to maintain adequate gas exchange |
|
|
Term
| What length of intubation would indicate need for a tracheostomy instead of an ET tube? Why? |
|
Definition
| 10 to 14 days. To reduce tracheal and vocal cord damage |
|
|
Term
|
Definition
| Maintain a patant airway and provide a means to remove secretions and provide ventilation and oxygen |
|
|
Term
| When properly placed - where does the tip of the ET tube rest? |
|
Definition
| About 2cm above the carina (the point at which the trachea divides into the riht and left bronchi) |
|
|
Term
| What route is not used for intubation if the patient has a blood clotting problem? |
|
Definition
|
|
Term
| When would the nasal route of intubation be used? |
|
Definition
| facial or oral traumas/surgeries |
|
|
Term
| Who usually performs an intubation? |
|
Definition
| An anesthesiologist, nurse anesthetist, or pulmonologist. |
|
|
Term
| Can patients talk with an ET tube with an inflated cuff? |
|
Definition
| No. Only a minimal amount of air can pass around the cuff |
|
|
Term
| What is the purpose of the pilot balloon? |
|
Definition
| Permits air to be inserted into the cuff and prevents air from excaping. This bslloon is a guide for determining when air is present in the cuff, but not how much or how little is present |
|
|
Term
| What to do while preparing for intubation |
|
Definition
Know proper procedure for summoning intubation personnel
Explain the procedure to the patient as clearly as possible.
Obtain a patant airway
delivery 100% oxygen by a manual reuscitation bag with a facemask until help arrives |
|
|
Term
What should be brought to the bedside of a patient requiring emergency intubation and ventilation?
What should be done until the patient is intubated? |
|
Definition
Crash card
Airway equipment box
suction equipment
Insert oral or nasopharyngeal airway until the patient is intubated |
|
|
Term
| What should the nurse be doing during intubation? |
|
Definition
Monitor VS
Monitor S&S of hypoxia or hypoxemia
Monitor for aspiration
Monitor for dysrhthmias
Ensure each intubation attempt lasts no longer than 30 seconds (preferably 15 seconds)
After 30 secodns, provide oxygen by means of mask and bag to prevent cardiac arrest
Suction as neccisary |
|
|
Term
| How is tube placement verified? |
|
Definition
Check end-tidal carbon dioxide levels and
chest x ray |
|
|
Term
| If breath sounds and chest wall movement are absent on the left side after intubation, what would that mean? |
|
Definition
| the tube may be in the right mainstream bronchus. Should be able to reposition without repeating the entire intubation procedure |
|
|
Term
| What would happen if the intubation tube is in the stomach? |
|
Definition
| abdomen may be distended and must be decompressed with insertion of an NG tube. |
|
|
Term
| How is the intubation tube stabalized? |
|
Definition
| tube is marked where it touches the incisor tooth or naris. Two people use a head halter technique to secure the tube. |
|
|
Term
| What might be used to prevent the patient from biting an oral endotracheal tube? |
|
Definition
|
|
Term
| When are restraints used to prevent accidential extubation? |
|
Definition
|
|
Term
| How are positive pressure ventilators classified? |
|
Definition
| By the mechanism that ends inspiration and starts expiration |
|
|
Term
| What are the four major ways that inspiration is cycled on positive pressure ventilators? |
|
Definition
Pressure cycled ventilators push air into the lungs. (Bi-Pap)
Time cycled ventilators Push air into the lungs untila preset time has elapsed. Tidal volume and pressure vary
Volume cycled ventilators push air into the lungs until a preset volume is delivered
Microprocessor ventilators are computer managed positive pressure ventilators |
|
|
Term
| What is the mode of ventilation? |
|
Definition
| The way in which the patient breaths from the ventilator |
|
|
Term
| What is assist Control ventilation (AC) |
|
Definition
| Used as a resting mode. The ventilator takes over the work of breathing for the patient. Tidal volumeand ventilatory rate are preset. If patient is able to breath, machine responds to patient's inspiratory effort allowing them to set the breathing rate. If no inspiratory effort, machien establishes rate |
|
|
Term
| Disadvantage of AC mode of mechanical ventilation |
|
Definition
| Ventilator delivers a preset tidal volume even when patient's spontaneous breathing rate increases. This can cause hyperventilation. |
|
|
Term
| Synchronized intermittent manditory ventilation (SIMV) |
|
Definition
| Tidal volume & ventilatory rate are preset. Patient is able to breath spontaneously at own rate and tidal volume between ventilator breaths. Can be used for weaning or as main mode. If weaning, gradually decrease number of mechanical breaths. When patient initiates breath, manditory ventilator breaths are delivered when patient is ready ti inspire |
|
|
Term
| Bi-level positive airway pressure |
|
Definition
| non-invasive. nasal mask or face mask. |
|
|
Term
What is tidal volume?
What would be a normal prescribed volume? |
|
Definition
volume of air patient receives with each breath, as measured on either inspiration or expiration.
usually between 7-10ml/kg of body weight. Add a 0 to patient's body weight in KG |
|
|
Term
| What rate are ventilators usually set at |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Why is air warmed to body temperature and humidified to 100%? |
|
Definition
| Because upper air passages of respiratory tree which normally warm and humidify air are bypassed. |
|
|
Term
|
Definition
| pressure used by the ventilator to deliver a set tidal volume at a given lung compliance. |
|
|
Term
| What would an increased PIP signify? |
|
Definition
| Increased airway resistance in the patient or in the ventilator tubign (bronchospasm or pinched tubing) increased secretions, pulmonary edema, or decreased pulmonary compliance |
|
|
Term
| What is decreased pulmonary compliance? |
|
Definition
| lungs or chest wall are "stiffer" or harder to inflate |
|
|
Term
| Why is an upper pressure limit set on ventilator? what happens if the limit is reached? |
|
Definition
| To prevent barotrauma. When the limit is reached, the high-pressure alarm sounds and the remaining volume is not given. |
|
|
Term
|
Definition
| Applies positive airway pressure throughout entire respiratory cycle for spontaneously breathing patients. |
|
|
Term
| What is important to remember about sedation for patients on CPAP |
|
Definition
| Sedation should be given lightly or not at all as not to depress spontaneous respiration |
|
|
Term
What process increases FRC and improves oxygenation?
What is FRC? |
|
Definition
| CPAP increases Functional residual capacity. |
|
|
Term
| What does the need for PEEP indicate? |
|
Definition
| A severe gas-exchange problem. It is important to lower the FiO2 delivered whenever possible because prolonged use of higg FiO2 can damage lungs from toxic effects of oxygen |
|
|
Term
| What is the amount of PEEP usually dialed in on the control panel? |
|
Definition
|
|
Term
| What indicates teh flow rate on a mechanical vent is set too low? |
|
Definition
| patient is agitated, restless, has widely fluctiating inspiratory pressure reading, or other signs of air hunger |
|
|
Term
Why is it important to address the psychological concerns of the patient and family of a patient with mechanical ventilation?
how should you handle this? |
|
Definition
Mechanical ventilation causes anxiety. Explainteh purpose of te vent.
Acknowledge that the patient might feel some different sensations.
Ecnourage patient and family to express concerns.
Act as the coach to help support them. |
|
|
Term
| What are nursing priorities when caring for a patient during mechanical ventilation? |
|
Definition
| Monitoring and evaluating patient responses, managing the ventilator system safely,and preventing complications |
|
|
Term
| How often should the area around the ET tube or tracheostomy site be assessed and for what? |
|
Definition
| every 4 hours for color, tenderness, skin irritation, and drainage, and document the findings. |
|
|
Term
| What should be done quickly if the patient develops respiratory distress during mechanical ventilation? |
|
Definition
| remove the ventilator and provide ventilation with a bag-valve mask device. This action allows quick determination of whether the problem is with the ventilator or the patient. |
|
|
Term
| What methods of communication can meet the ventilated patient's needs? |
|
Definition
slate
picture board
pen and paper
alphabet board
programmable speech generatign device |
|
|
Term
| Why is finding a successful means for communication important for a ventilated patient? |
|
Definition
| patient often feels isolated as a result of the inability to speak |
|
|
Term
| What are important ways of giving patient's a sense of control over the environment when mechanically ventilated? |
|
Definition
Anticpate needs and provide easy access to frequently used belongings.
Visits from family and friends (pets?)
keep call light within reach
Urge participation in self-care |
|
|
Term
| who is in charge of ventilator settings? |
|
Definition
| Prescribed by the physician in conjunction with the respiratory therapists. It is important to check the actual settings to the prescribed settings, as well as the level of water in the humidifier and the temp of humidifying system. Tep extremes damage the airway mucosa. Remove any condensation in the ventilator tubing by draining water into drainage collection receptacles and empty them every shift |
|
|
Term
| Why is it important not to allow moisture and water in the ventilator tubing to enter the humidifier? |
|
Definition
| To prevent bacterial contamination |
|
|
Term
| What should be done if you cannot determine the cause of an alarm on a mechanical ventilator? |
|
Definition
| Ventilate the patient manually with a resuscitation bag until the problem is correted by another health care professional |
|
|
Term
| What are the two major alarms on a ventilator? |
|
Definition
High pressure
Low exhaled volume |
|
|
Term
| Where is the ET tube likely to move if it moves down? |
|
Definition
| Into the right mainstem bronchus |
|
|
Term
| what should be monitored during transportation of a mechanically ventilated patient? |
|
Definition
|
|
Term
| What cardiac problems can be caused by mechanical ventilation? |
|
Definition
| hypotension (caused by positive pressure that increases chest pressure and decreas blood return to the heart)and fluid retention |
|
|
Term
Valsalva maneuver
who should avoid? |
|
Definition
bearing down while holding the breath
mechanically ventilated patients |
|
|
Term
| What should be addressed with mechanically ventilated patients with hypotension |
|
Definition
|
|
Term
|
Definition
| Damage to lungs by positive pressure |
|
|
Term
|
Definition
| damage to lungs by excess volume delivered to oen lung over the other |
|
|
Term
| What may be prescribed to help prevent ulcers in the ventilated patient? |
|
Definition
| antacids, sucralfate, zantac, or proton pump inhibitors (Nexium) |
|
|
Term
| What leads to paralytic ileus in an mechanically ventilated patient? |
|
Definition
| changes in chest and abdominal cavity pressure |
|
|
Term
| What nutrient is of concern for a patient with COPD |
|
Definition
| Carbohydrates. Carbohydrates break down into glucose which breaks down into carbon dioxide |
|
|
Term
| How long does it usually take for an artifical airway to become colonized with bacteria? |
|
Definition
|
|
Term
| How often should oral care be performed on an intubated patient? |
|
Definition
|
|
Term
| What is ventilator dependence? |
|
Definition
| inability to wean off ventilator. Usually physiologic but can be psychological. |
|
|
Term
|
Definition
Have equipment for reintubation
hyperoxygenate
suction ET tube & Oral cavity
Rapidly deflate the cuff of the ET tube & remove the tube at peak inspiration.
Instruct patient to cough
Give oxygen (usually 10% higher than when ET tube was in) |
|
|
Term
| What should you do if there are large amounts of oral secretions at extubation? |
|
Definition
| nothing, this is normal, encourage patient to cough |
|
|
Term
| Should patients be encouraged to speak after extubation? |
|
Definition
| No. Limit speaking. Vocal cords will be sore |
|
|
Term
| How often should vital signs be monitored after expiration? |
|
Definition
|
|
Term
| What is a pulmonary contusion? |
|
Definition
Potentially lethal
Caused by rapid deceleration during car crashes. Respiratory failure develops over time. Can lead to ARDS |
|
|
Term
What is flail chest?
Who is this common in? |
|
Definition
Inward movement of the thorax during inspiration with outward movement during expiration.
Car crashes, CPR, & older adults. high mortality rate |
|
|
Term
| How is flail chest usually stablized? |
|
Definition
| positive pressure ventilation. Extreme cases would be surgery |
|
|
Term
| Nursing management of flail chest |
|
Definition
Monitor vs & F&E balance so that shock can be caught and managed early.
Monitor CVP
Give IV fluids as prescribed
Give psychosocial support |
|
|
Term
| Which way does the trachea deviate during open pneumothorax? |
|
Definition
| Towards the affected side |
|
|
Term
| Which way does the trachea deviate during a closed pneumothorax? |
|
Definition
| Away from the affected side |
|
|
Term
|
Definition
| Air under the skin in the subcutaneous tissue |
|
|
Term
|
Definition
rapidly developing life threatening
Complication of blunt chest trauma
Results from an air leak in the lung or chest wall
Air forced into the chest cavity causes complete collapse of affected lung. Air that enters the pleural space during inhalation can't escape. High pressures, limited blood flow, pressure on heart (death) |
|
|
Term
| Assessment findings with tension pneumothorax |
|
Definition
asymmetry of thorax
Trachea movement away from midline towards unaffected side
resp distress
absennce of breath sounds
distended neck veins
cyanosis
hypertympanic sound over affected side |
|
|
Term
| What way would the trachea deviate with a tension pneumothorax? |
|
Definition
| away from the midline toward the unaffected side |
|
|
Term
| How is pneumothorax diagnosed |
|
Definition
Chest X ray shows
ABG shows hypoxia and respiratory alkalosis |
|
|
Term
| What is the first line treatment for tension pneumothorax? |
|
Definition
| large bore needle inserted into second intercostal space in the midclavicular line of the affected side |
|
|
Term
|
Definition
| Common problem occuring after blunt chest trauma or penetrating injuries. Blood loss into the chest cavity |
|
|
Term
|
Definition
| blood loss of less than 1500ml into the chest cavity |
|
|
Term
|
Definition
| blood loss of more than 1500ml into the chest cavity |
|
|
Term
|
Definition
cuased by blunt trauma or rapid deceleration.
develop air leacks causing extensive subcutaneous emphysema. May develop tension pneumothorax if intubated with positive airway pressure. Shock is likely. Hypotension is likely. |
|
|
