The client is admitted to the emergency department with chest trauma. What signs/symptoms indicate to the nurse the diagnosis of pneumothorax?

Barrel chest and polycythemia

Bronchovesicular lung sounds and bradypnea

Unequal lung expansion and dyspnea

Frothy bloody sputum and consolidation

Answer and Explanation

The Correct Answer is C

A. Barrel chest and polycythemia: These findings are more characteristic of chronic obstructive pulmonary disease, especially emphysema. They reflect long-term adaptations to hypoxia and air trapping, not the acute onset seen in pneumothorax.

B. Bronchovesicular lung sounds and bradypnea: Bronchovesicular sounds are normal in some lung areas, and bradypnea is not a common feature of pneumothorax. Pneumothorax often presents with decreased or absent breath sounds on the affected side and increased respiratory rate due to hypoxia.

C. Unequal lung expansion and dyspnea: Unequal chest expansion occurs because the collapsed lung on the affected side does not inflate properly. Dyspnea results from impaired gas exchange, making this the most accurate sign combination of pneumothorax.

D. Frothy bloody sputum and consolidation: These findings suggest pulmonary edema or pneumonia rather than pneumothorax. Frothy sputum is often seen in left-sided heart failure, and lung consolidation is not a feature of air in the pleural space.

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Correct Answer is A

Explanation

A. Lint-free pipe cleaner:A lint-free pipe cleaner is ideal for drying the inner cannula because it won’t introduce fibers or debris into the airway. It ensures that the cannula is thoroughly dried without increasing the risk of aspiration or airway irritation from lint.

B. The inner cannula does not need to be dried before reinserting it into the outer cannula:Moisture left inside the cannula can promote bacterial growth and lead to infection. Drying the cannula is an essential step to prevent microbial contamination and to maintain patency and safety.

C. Q-tip:Q-tips can shed fibers and are not suitable for internal tracheostomy components. Using them may lead to lint being introduced into the airway, increasing the risk of irritation or infection.

D. Medical air:Medical air is not used to dry tracheostomy components. It is not practical, and it may not fully dry narrow internal surfaces. Manual drying with a lint-free material is safer and more effective.

A. "I have cared for patients who were able to have the tracheostomy reversed." B. “I understand that you might be apprehensive." C. “I will be efficient and give care quickly." D. "I will wait until your tracheostomy heals before teaching."

Correct Answer is B

Explanation

A. "I have cared for patients who were able to have the tracheostomy reversed. While this may offer hope, it shifts the focus to long-term outcomes rather than addressing the patient's current emotional state. Not all tracheostomies are reversible, and offering this reassurance prematurely may set unrealistic expectations.

B. “I understand that you might be apprehensive." This statement acknowledges the patient's anxiety and fosters trust. Demonstrating empathy helps reduce emotional distress, encourages open communication, and supports emotional adaptation to the tracheostomy.

C. “I will be efficient and give care quickly." Although efficiency is important, this response may come off as dismissive of the patient's emotional needs. It prioritizes task completion over patient-centered care and fails to address the underlying anxiety.

D. "I will wait until your tracheostomy heals before teaching." Teaching should begin early, even in small steps, to help the patient gradually understand and adapt to tracheostomy care. Delaying education may increase fear, uncertainty, and dependence on others for care.

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The client is admitted to the emergency department with chest trauma. What signs/symptoms indicate to the nurse the diagnosis of pneumothorax?

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