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Pneumothorax&;hemothorax

PNEUMOTHORAX&HEMOTHORAX
Definition
causes
signs and symptoms
nursing careplans
medical management
complications

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Pneumothorax&;hemothorax

  1. 1. PNEUMOTHORAX & HEMOTHORAX MANAGENT IN E.R. Gufu ABDIKADIR BSCN/2015/40718
  2. 2. PNEUMOTHORAX …
  3. 3. DEFINITION  *lung disorder whereby there is collection of air in the pleural space that causes partial/whole collapse of the lung
  4. 4. Pathophysiology  May be caused by trauma secondary to medical procedure e.g. thoracocentesis  (*thoracentesis is a procedure to pleural fluid from the pleural space either for RX/Dx purposes.  Normal physiology; pressure in lungs is greater than pressure in pleural cavity  Pathophysiology; trauma = air enters the pleural space thus pleural space pressure is equal/higher than lung pressure. ^se in pressure leads to lung collapse, compresses the heart and pushes it towards the unaffected side.  Thus pneumothorax should be managed in the ER AS FAST AS POSSIBLE.
  5. 5. Types of Pneumothorax Spontaneous PNEUMOTHORAX  Occurs suddenly with no known reason. Result from rupture of small air sacs.  Occurs commonly in men aged 20-40y who are tall and thin in nature. It also affects people sufferin from TB, cystic fibrosis of the lungs. Traumatic PNEUMOTHORAX  results from medical procedure e.g MV&thoracocentesis. Tension PNEUMOTHORAX  Life threatening; caused by traumatic injury. Air enters chest cavity and cannot escape. This = to extreme ^se in pressure in pleural cavity than the lungs leading to lung collapse and compression of the heart.
  6. 6. Causes 1. IDIOPATHIC; tall thin men 2. blunt/penetrating chest injury e.g gunshot 3. certain medical procedures e.g MV 4. damage from underlying lung disease e.g TB
  7. 7. Who is at risk?
  8. 8. Signs and symptoms 1. chest pain; sudden, sharp in nature esp. on deep breathing and coughing 2. shortness of breath; due to decreased pressure in the lungs
  9. 9. ManAgement AIM;  Relieve pressure on the lungs to ensure normal breathing by removing air  Re-expanding the lungs  Preventing re-ocurrence REMEDIES; i. Observation; with mild/no symptoms simple close monitoring with a series of chest X-rays until the air is completely absorbed and the lung has re- expanded.  Requires bed rest as any exertion may aggravate the collapse.  Supplemental oxygen can speed the absorption process
  10. 10. Dx  Auscultation; physical  chest x ray- show the air pocket and the collapsed lung  electrocardiogram (ECG) will be performed to record the electrical impulses that control the heart's activity  Blood sample for ABG analysis.
  11. 11. Cont…  Needle Aspiration/Chest tube insertion larger area of lung has collapsed, chest tube will be used to remove the air. The hollow needle or tube is inserted between the ribs into the air-filled space that is pressing on the collapsed lung. With the needle, a syringe is attached so the doctor can pull out the excess air - just like a syringe is used to pull blood from a vein. Chest tubes are often attached to a suction device that continuously removes air from the chest cavity and may be left in place for several hours to several day
  12. 12. NURSING CAREPLAN ASSESSMENT;
  13. 13. NURSING DX  Ineffective breathing pattern r/t impaired lung expansion as evidenced by shortness of breath  Impaired gas exchange r/t collapse of the lung tissue as evidenced by decreased arterial blood gas analysis  Acute pain related to increased pressure in the pleural cavity
  14. 14. Nursing Intervention
  15. 15. hemothorax …
  16. 16. Definition  Collection of blood in the pleural cavity  Special type of pleural effusion in which blood accumulates in the pleural cavity. This excess fluid can interfere with normal breathing by limiting the expansion of the lungs..
  17. 17. Causes • blood not clotting properly and leaking into the chest cavity • cancer in the lungs • fluid and cancer around the lungs, called malignant pleural effusion • cancerous tumors in your chest wall • large vein torn open when a catheter is inserted while you’re in the hospital • tissue around your lungs dying, called pulmonary infarction • Trauma; blunt/penetrating
  18. 18. SIGNS&SYMPTOMS • pain or feeling of heaviness in your chest • feeling anxious or nervous • dyspnea, or having trouble breathing • breathing quickly short • abnormally fast heartbeat • breaking out in cold sweats • skin turning pale
  19. 19. DX  CT SCAN  X-RAY
  20. 20. Medical mgt  Chest tube insertion  Surgery
  21. 21. Nursing Careplan REFER PTX ABOVE

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PNEUMOTHORAX&HEMOTHORAX Definition causes signs and symptoms nursing careplans medical management complications

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