Essay on Pneumothorax

Upon observation of the circulating nurse, I noticed that she was very interactive and involved in the surgery. One of the responsibilities of the circulating nurse is to retrieve any surgical supplies that are not available in the operating room and to make or receive any calls for the surgeon. During the surgery, I noticed the nurse call for an x-ray for the surgeon, the laboratory for biopsy samples, and the operating room floor front desk to inform them that the surgery would be later than expected. This is her responsibility as the surgeon cannot break sterility by touching the phone and it is easier for him to communicate through her and not leave the surgical site. Also in the operating room, I observed the scrub nurses’ roles. Before the operation, the scrub nurse opened all of the sterile packages, arranged them on the sterile field, and took count of what was there along with the circulating nurse. The scrub nurse did this because she is sterile during the entire procedure, and once the sterile packs are opened, the contents can only be handled by sterile personnel. The scrub nurse also was ready and waiting at the sterile field at all times to get the surgeon any equipment needed from the sterile field. This is helpful to the surgeon because it enables the surgeon to stay at the surgical site and convenient for when

B. The muscles that help move air in and out of the lungs are severely compromised.

The majority of nurses are still auscultating air insufflation over the abdomen to check the placement of nasogastric tubes, since it was the method that was taught for many years. It is an easy and less expensive way to check the placement, but research has shown that it is not reliable. Research showed that sounds can be transmitted to the epigastrium no matter where the nasogastric tube is placed. It does not matter if it is in the lungs, esophagus, or stomach, it can still be heard through the stethoscope (De Boer, J., Smit, B., Mainous, R., 2009).

Due to the mechanical ventilator, it is able to assist in oxygen perfusion to all of her tissue. Thus, the lungs will be able to expand appropriately.

She is with the patient throughout the full process. Before the operation, she will prepare the patient to receive the anesthesia and will perform a full patient assessment. This determines any patient allergies to certain chemicals or drugs; what medicine the patient can receive; how their bodies will react; and where the injection should be administered. Sometimes, the drug will be given in the form of an onsite injection, similar to an epidural. When the operation begins, Kelly will then assist the physician with monitoring and administering the anesthesia to ensure proper sedation. If the patient is not fully put to sleep, and a portion of his or her body is numbed instead, she monitors the input on the site of injection and ensures the patient cannot feel anything throughout their body. When the procedure is concluded, Mrs. Leonard’s duties will continue. She is in charge of overseeing that the patient recovers from the anesthesia smoothly and cares for the patient’s post-operative needs until they are

This makes the assembly less cumbersome, and if properly trained, the measurement and drainage can be carried out sufficiently safely by the patient. The Heimlich valve system does not restrict the patient to the bed. This allows for patients who may require prolonged drainage to be nursed in the outpatient setting while being sufficiently independent. Additionally, there is no danger of the drained effluent, or air flowing back into the chest with assumption of a different or dependent position relative to the collecting bag. With a well secured thoracostomy tube, the patient enjoys relative freedom in terms of nursing positions (10).

It causes a decrease in lung functions, and very often, shows signs of breathlessness. It is indeed a destructive disease of the lung in which the alveoli (small sacs) that promote oxygen exchange between the air and the bloodstream are destroyed. Emphysema is a progressive, degenerative kind of disease that destroys many alveolar walls. As a result, clusters of small air sacs merge into larger chambers, which decrease the total surface area of the alveolar walls. At the same time, the alveolar walls lose their elasticity and the capillary networks associated with the alveoli diminish (Shier et al; 2010). It is in this sense that a person with emphysema finds it very difficult and increasingly hard to breath, has to force air out of the lungs because the tissue elasticity of the lungs and for that matter, the alveolar sacs have reduced or completely destroyed. Furthermore, abnormal muscular efforts are required to compensate for the lack of elastic recoil that normally contributes to

The nurse should also administer supplemental oxygen as indicated, Insert and maintain IV access, reduce patient stimulation, tell the patient to splash cold water on their face, or to do a vagal movement to help decrease heart rate (Kyle, 2012).

Critical Thinking: During the first scenario, the patient was a 39-year-old female admitted to a med-surg unit following an abdominal hysterectomy. She had no known allergies and had a Foley catheter in place. Also the physician’s orders included, sequential compression devices and pain medication. While receiving report about my patient, I was beginning to think, as a nurse what my priority would be when first entering the patient’s room, which would be performing an assessment, monitoring vitals, assessing pain and inspecting the surgical site and dressing for signs and symptoms of infection, and assessing for potential post-op complications such as respiratory and cardiac problems; however, that didn’t go as planned. I was too focused on being reactive and thinking about what I was going to do next instead of being proactive, that I forgot simple steps such as introducing myself to the patient. Moreover, in the second scenario, my colleagues and I were placed in the emergency department to care for a 34-year-old patient with complaints of difficulty breathing due to asthma. In this scenario, the physician’s order consisted of administering oxygen via nasal cannula as needed in addition to administering albuterol via the nebulizer. Once again, before entering the patient’s room, I knew my first priority was going to be to assess the patient’s respiratory status by auscultating breath sounds, examining the quality and rate of respirations, the shape and configuration of the

During inhalation the air sacs pull in oxygen and during exhalation the air sacs let out carbon dioxide. This gas exchange should happen without complication but with pulmonary edema fluid fills up in the alveoli in place of air, averting the bloodstream from absorbing oxygen. Pulmonary edema usually requires a hospital stay of a few days or longer. Patients are seen by several specialists during their hospital stay. Once the condition is controlled, outpatient treatment with a cardiologist or a pulmonologist is recommended (Mayo Clinic

There are different classification categories for pneumothorax. According to etiology, pneumothorax is classified as either spontaneous or traumatic.

Pleural involvement in CT can be seen as pleural effusion, plaques, discrete pleural nodules, or a combination. Pleural biopsy and pleural fluid cytologic examination are usually early steps in the diagnostic workup of patients with pleural-based masses. Primary pleural lymphoma is extremely rare. By contrast,pleural involvement by systemic lymphoma is relatively common. Approximately 16% of patients with non- Hodgkin lymphoma present with, or subsequently develop, pleural involvement during the course of disease. Pleural involvement can be unilateral or bilateral and is more common on the left side (Vega et al., 2006).

Dyspnea was the commonest symptoms seen in all patients followed by cough and fever. Half of the patients had crackles on examination, and half were hypoxic at rest. Chest x ray showed some abnormality in 80% of cases. CT of chest is more sensitive and showed ground glass densities in 65% of cases followed by nodules in 53%. Pulmonary functions tests revealed obstruction in one third of cases. Most cases were diagnosed based on sputum examination. Transbronchial biopsy was able to establish diagnosis 75% of cases. Biopsy showed granuloma in 92% of cases. One third of patients received Antimycobacterial drugs alone and 16% of patients received steroids alone. The specific dose and duration of steroids is not reported accurately in literature and hence the optimal regime of steroid therapy is not known. If antimycobacteral treatment is considered, then American Thoracic Society(ATS) recommends treatment with three drug Azithromycin/Clarithromycin, Ethambutol and Rifampin for 12 to 18 months. While 23% of patients received both treatment, 20% of patients were not given any specific treatment except abstinence from source. Despite of the type of treatment regime used, clinical response was seen in all patients and 60% patients showed complete resolution. No death due to HTL has been reported till date.

Around 2 million Americans suffer from emphysema. Emphysema is known as a disease of the lung that cause shortness of breath due to over inflation of the alveoli or air sacs in the lungs. It is a progressive and irreversible condition in which the alveoli are damaged by inhaled irritants. In this paper I will be discussing with you the causes, the process in which this disease develops, signs and symptoms, the diagnosis, and any treatment of emphysema.

The greatest advantage of fine needle aspiration is safety. Fatal complications like systemic air embolism , haemorrhage or pericardial tamponade have been described. However, pneumothorax remains the most common complication of CT-guided lung FNAC. Review of the existing literature reveals variable rates of pneumothorax, ranging from 5 to 64% . Pneumothorax was noted in 36.2% patients of my study population. In three patients (5.2%) moderate pneumothorax was seen requiring chest tube placement. It was found that the amount of lung traversed by the needle & size of the lesion is significantly associated with development of pneumothorax. The more the amount of the lung tissue traversed by the lesion the more was the complication rate and the