A patient arrives in the ED after an automobile accident. Which of the following clinical manifestations leads the nurse to suspect a pneumothorax? (Select all that apply)
(Select All that Apply.)

Pulse oximetry 98%

Diminished breath sounds over painful chest area

Respiratory rate 34

ABG pH level of 7.38

Asymmetrical chest movements, especially on inspiration

Answer and Explanation

Correct Answer : B,C,E

A. Pulse oximetry 98%: A pulse oximetry reading of 98% indicates adequate oxygen saturation, which does not strongly suggest a pneumothorax. Patients with a pneumothorax may have lower oxygen saturation levels, but this reading alone is not indicative of the condition.

B. Diminished breath sounds over painful chest area: Diminished breath sounds are a significant clinical manifestation of pneumothorax, as air in the pleural space prevents normal lung expansion and decreases airflow to the affected side.

C. Respiratory rate 34: An elevated respiratory rate (tachypnea) is often observed in patients with pneumothorax as they may struggle to breathe effectively. This clinical manifestation indicates respiratory distress and is consistent with the condition.

D. ABG pH level of 7.38: A pH level of 7.38 indicates acidosis, which may occur in cases of pneumothorax due to impaired gas exchange and respiratory distress. This abnormal finding on arterial blood gases supports the suspicion of pneumothorax.

E. Asymmetrical chest movements, especially on inspiration: Asymmetrical chest movements are a classic sign of pneumothorax, where the affected lung does not expand as fully as the unaffected lung during inspiration, leading to visible differences in chest wall movement.

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Correct Answer is A

Explanation

A. We will have to drain the pus out of your pleural space: An empyema is characterized by the accumulation of pus in the pleural space, typically due to infection or inflammation. The primary treatment often involves draining the infected fluid to relieve symptoms and treat the underlying infection, making this statement accurate and appropriate for the patient.

B. These blebs in your lungs can rupture with exercise: This statement is not applicable to empyema. Blebs are associated with conditions like pulmonary bullae or emphysema, not empyema. Empyema specifically refers to pus in the pleural space, not blebs in the lungs.

C. You will be given a long course of antiviral medication: Antiviral medication is not typically indicated for empyema, as it is often caused by bacterial infections. Treatment usually involves antibiotics and drainage rather than antiviral therapy.

D. We will watch you for respiratory muscle fatigue: While monitoring for respiratory status is important in any patient with empyema, this statement does not specifically address the nature of empyema or its treatment. The focus should be on managing the infection and drainage of the pleural space.

A. Administration of broad spectrum antibiotics B. Administration of drugs that decrease airway inflammation C. Avoidance of the causative agent D. Administration of drugs that reduce bronchospasm

Correct Answer is C

Explanation

A. Administration of broad-spectrum antibiotics: Broad-spectrum antibiotics are not a primary treatment for asthma, as asthma is an inflammatory condition and not primarily caused by bacterial infections. Antibiotics may be used for coexisting infections but are not the most successful initial treatment for chronic asthma.

B. Administration of drugs that decrease airway inflammation: While decreasing airway inflammation is important in managing asthma, the most successful long-term treatment begins with addressing the underlying causes and triggers. Reducing inflammation is part of the treatment strategy but is not the first action.

C. Avoidance of the causative agent: Avoiding the causative agent or trigger of asthma is the most successful initial treatment. Identifying and eliminating exposure to allergens or irritants, such as pollen, smoke, or pet dander, can significantly reduce the frequency and severity of asthma attacks, making it the foundational step in asthma management.

D. Administration of drugs that reduce bronchospasm: Medications that reduce bronchospasm, such as bronchodilators, are essential for immediate relief of asthma symptoms. However, they do not address the underlying inflammation and triggers, making avoidance of causative agents the most successful initial treatment for chronic asthma.

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A patient arrives in the ED after an automobile accident. Which of the following clinical manifestations leads the nurse to suspect a pneumothorax? (Select all that apply) (Select All that Apply.)

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A patient arrives in the ED after an automobile accident. Which of the following clinical manifestations leads the nurse to suspect a pneumothorax? (Select all that apply)
(Select All that Apply.)