Pneumothorax

Pneumothorax is caused by air in the pleural space. This can result in complete or partial collapse of a lung due to the build up of air in the pleural space.
1. 1. collapsed lung
NURSING CARE & MANAGEMENT
1. PAIN MANAGEMENT
  1. pharmacological
  2. subjective description & pain scale
2. PHYSICAL ASSESSMENT
  1. Signs & Symptoms
    1. dyspnea
    2. Sudden onset of chest pain - SHARP & PLEURITIC (Ryan, 2005).
    3. limited movement of involved chest wall
      1. asymmetrical chest movement
    4. Diminished or absent breath sounds
    5. cyanosis
    6. open chest wound
      1. audible air escaping from chest wound
    7. rapid, thready pulse
    8. decreased blood pressure
      1. asymmetrical blood pressure values in arms
      2. narrowed pulse pressure
    9. bruising
    10. decreased O2 saturation
    11. tracheal deviation
    12. abrasions
    13. Mental status changes - due to decreased cardiac output
3. DIAGNOSTIC TESTS
  1. Chest Radiograph
  2. CHEST XRAY
  3. Electrocardiogram
4. Patient in upright position
5. Chest drain tube - inserted into the pleural space & attached to an underwater seal drainage bottle (Briggs, 2010).
  1. aseptic technique
  2. analgesia prior to insertion
TYPES
1. Primary spontaneous pneumonthorax is when the patient has no obvious underlying lung disease (Briggs, 2010).
  1. HIGH RISK: young, men with low body weight and smoking
  2. Secondary spontaneous pneumothorax occurs when the invidual has underlying lung disease (Briggs, 2010).
    1. LUNG DISEASE
      1. COPD
      2. weakens the alveolar-pleural barrier (Ryan, 2005).
  3. Closed Pneumothorax - not caused by trauma or external wound. Caused by ruptures of air-filled alveoli (blebs) on the edge of the lungs
  4. Catamenial Pneumothorax - RARE CONDITION - onset during a woman's menstrual period (The Lung Association, 2012).
    1. Women in their 30 & 40s
2. Open Pneumothorax - caused by air entry to the pleural space through an external wound, permeating the chest wall
  1. Vented dressing - dressing secured on 3 sides of the opening. Fourth side left open to allow air to pass through
    1. decreases chance of tension pneumothorax
3. Tension Pneumothorax - increased tension in the pleural space due to rapid build up of air, which increases intrapleural pressure
  1. life-threatening complication - occuring in 1-3% of spontaneous pneumothorax (Ryan, 2005).
  2. causes lung collapse on affected side
    1. increased pressure causes mediastinum and compression of the contralateral lung, heart and great vessels (Ryan, 2005).
4. Traumatic Pneumothorax - caused by blunt or penetrating trauma (Ryan, 2005).
  1. Gun wound
  2. rib fracture
  3. Car accident
  4. Fall
AVOID SCUBA DIVING to prevent recurrence (The Lung Association, 2012).

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Pneumothorax

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	Created by Amanda Coutch about 8 years ago