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
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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Related Questions
Correct Answer is A
Explanation
A. Actually, people who have the latent form of the disease won't be sick and can't spread it either: This response is accurate because individuals with latent tuberculosis infection (LTBI) do not exhibit symptoms and are not infectious. They carry the bacteria in their body, but it remains dormant and does not spread to others. Only those with active tuberculosis disease are capable of transmitting the infection through respiratory droplets.
B. Many people do manage to fight off the infection, but you are right: they can still spread it by coughing or sneezing: This statement is misleading because it implies that individuals with LTBI can spread the disease, which is not the case. Only those with active TB are contagious.
C. There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past: This response downplays the importance of understanding the difference between latent and active TB and could create confusion. Vaccination for tuberculosis (BCG vaccine) is not routinely given in the United States, and exposure alone does not necessitate vaccination.
D. If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease: This statement is incorrect, as individuals who have been exposed but have LTBI are not infectious. It is only those with active TB who pose a risk of spreading the infection.
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.
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