Essay on Pneumothorax

1322 Words Sep 22nd, 2012 6 Pages
1. Given the diagnosis of pneumothorax, explain why the paramedic had difficulty ventilating A.W.
• Air escaped from the lung into the pleural space. Eventually, enough air collected in the pleural space to cause the mediastinum to shift twoard the right. The collapsed left lung, increased intrapleural pressure, and rightward shift make it difficult to ventilate A.W.

2. Interpret A.W.’s ABG’s
• Significant respiratory acidosis with profound hypoxemia. A.W. is near death.

3. What is the reason for A.W.’s ABG results?

• 70% of her right lung is collapsed and is not taking part in gas exchange

4. The physician needs to insert a chest tube. What are your responsibilities as the nurse?

Preinsertion:
• Support patient with
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As the nurse, it is your responsibility to ensure pain control. In A.W.s case, would you administer pain medication before the chest tube insertion?
• The client is stuporous on arrival to the emergency room and is in a medical emergency; you may or may not have time to administer pain medication. Preparing the chest tube set-up takes priority because your client is near death and this is what will reverse her grave situation. If you do have time after set-up or have other nurses helping you -- the quickest and fastest would be IV administration – it is a common order to administer morphine 2- 6 mg IV titrated (example: 2 mg at a time assessing each dose after approximately 5 minutes to see how the patient is doing; then giving 2 mg more, waiting, assessing; etc until pain relief is observed)

6. The ER physician inserts a size 32 chest tube in the 2nd intercostal space, midclavicular line. Many chest tubes are inserted in the 6th intercostal space, midaxillary line. What factor determines where a chest tube is placed?