MDC4 Exam 2 1. what are the assessment findings in pneumothorax? - ● Sudden dyspnea ● Chest pain ● Feeling of doom/anxiety ● JVD ● Tachy ● Chest petechiae ● ECG changes ● Abnormal heart sounds 2. what are the s/s of flail chest? - - paradoxical chest movement - dyspnea - cyanosis - tachycardia - hypotension 3. how does the patient usually present with flail chest? - - anxious - short of breath - in pain 4. what are interventions for flail chest - - humidified oxygen - pain management - promotion of lung expansion through deep breathing and positioning - secretion clearance by coughing and tracheal suction 5. can a person with flail chest recover? - manageable with vigilant respiratory care 6. when is mechanical ventilation needed for a patient with flail chest? - - respiratory failure - shock - severe hypoxemia and hypercarbia 7. nursing care for flail chest - - monitor ABGs - monitor vitals 8. with flail chest, what causes increase the risk of respiratory failure - - lung contusion - underlying pulmonary disease 9. how is flail chest usually stabilized? - positive pressure ventilation 10. what interventions are needed for low BP - - fluid replacement - Trendelenburg - compression stockings - medication 11. what causes a high pressure vent alarm? - - thick mucus/secretions blocking the airway - coughing - biting on tube - fighting vent - wheezing - bronchospasms - pneumothorax - displaced tube - obstruction - water in vent circuit 12. what causes a low pressure vent alarm? - - leak in circuit - cuff leak - patient disconnected *apnea alarm* 13. possible interventions for high pressure vent alarm - - check patient first! - check all tubing is connected and not kinked - suction patient - medication for pain, anxiety, sedation - change vent settings 14. what causes increased or thick secretions/mucus in a patient who is intubated - not enough humidity 15. possible interventions for low pressure vent alarms - - check patient first! - manually bag patient - reconnect/unkink tubing 16. nursing care of ventilated patient - - q2-4 respiratory assessment, oral care, suctioning if needed - q4 head to toe assessment and vitals - maintain head of bed 30 degrees - q2 turns - monitor I&O - collaborate with RT - monitor vent settings q8-12 - manual resuscitation bag at bedside 17. Vent Settings - - tidal volume - rate - FIO2