Exam 1 - Lung conditions

Question 1

Complications of pulmonary embolism

Answer 1

o	Cardiac arrest 
o	Death
o	Shock
o	Pleural effusion
o	Pulmonary hypertension

Question 2

Management of pulmonary embolism

Answer 2

o Ventilator
o Chest tube
o Anticoagulant and thrombolytic therapy
o For hypotension – dobutrex (dobutamine) or dopamine (intropin) to cause vasodilation
o Pain management
o Monitor bleeding times (PT, PTT, INR)
o Surgery – embolectomy, greenfield filter

Question 3

Prevention of PE

Answer 3

o Exercises to avoid venous stasis
o Early ambulation
o Anticoagulant therapy
o SCDs

Question 4

Complication of pleurisy

Answer 4

Severe knife-like pain

Question 5

Management of pleurisy

Answer 5

o Objective of treatment is to figure out the underlying condition and relieve pain
o As underlying condition is treated, pleuritic inflammation usually resolves
o Analgesic agents and topical applications of heat or cold provide symptomatic relief
o Turn frequently onto affected side to splin the chest wall and reduce the stretching of pleurae
o Teach pt to use hands or a pillow to splint the rib cage while coughing

Question 6

Prevention of pleurisy

Answer 6

o Difficult to have set methods of prevention d/t usually being caused by an underlying condition i.e. pneumonia, upper respiratory tract infection, trauma

Question 7

Complications of pneumothorax

Answer 7

Death

Recurrence

Question 8

Management of pneumothorax

Answer 8

o Depends on cause and severity

o Goal is to evacuate the air or blood from the pleural space via chest tube

Question 9

Prevention of pneumothorax

Answer 9

Can be spontaneous, traumatic, or tension

Question 10

Management of chest tubes

Answer 10

• Record drainage by marking with a permanent marker then figure from last shift how much you have pulled off.
• Only change when container is full
• Be aware of color, consistency, bubbling in drainage system (indicates leak), fluctuation of tubing with inhalation/exhalation
• Always have Vaseline sterile dressing at bedside

Question 11

Conditions that require chest tubes

Answer 11

Pneumothorax
Hemothorax
Empyema

Question 12

Chest tubes education

Answer 12

• Comes out when there is not much fluid anymore
• Used to drain either air or fluid
• Teach breathing and coughing techniques – splinting
• Keep area clean and dry – make sure pt has enough dressings to reinforce rather than change it
• Come to ER if there is a lot of drainage
• Mobility helps drain faster
• Report – dyspnea, significant drainage (bloody/purulent), fever, severe pain