Pneumothorax for Certified Emergency Nursing (CEN)

A paramedic radios data to the base station regarding the status of a 64-year-old man who is showing signs and symptoms of an acute tension pneumothorax after involvement in an automobile accident. The paramedics are instructed to perform a needle thoracotomy. The nurse anticipates that the paramedic will correctly insert the needle:

A 26-year-old man diagnosed with spontaneous pneumothorax is being monitored in the holding room overnight. Because the patient had limited symptoms and lung involvement, decompression of the pleural cavity was not initiated. Which assessment finding should the nurse report immediately to the physician?

A patient is status post insertion of a chest tube for pneumothorax, now has a well expanded lung, and the chest tube is positioned to allow for water-seal drainage without suction. The nurse should anticipate that the water-seal level would:

Which finding would be least useful in evaluating recurrence of a pneumothorax?

A woman with a history of coronary artery disease is standing outside a supermarket when she suddenly complains of chest pain and collapses in full cardiac arrest. Bystanders initiate basic life support measures until emergency medical technicians (EMTs) arrive. The paramedics properly intubate and ventilate the patient; an automatic chest compressor also is used. One of the paramedics radios the ED nurse, and informs that the patient is not responding. Which factor is probably not contributing to the patient’s unresponsiveness?

The nurse’s discharge instructions for a patient with a rib contusion and a minor rib fracture include information on the need to report fever, dyspnea on exertion, sputumproduction, or chest pain should any of these symptoms occur. These symptoms are indicative of:

A 64-year-old man with emphysema is admitted to the ED because of a sudden attack of dyspnea. Auscultation reveals no breath sounds over the right lung. The physician diagnoses spontaneous pneumothorax and inserts a chest tube. The patient’s chest tube is ordered to be on suction, at -20 cm of water pressure. When checking the chest tube drainage system at the start of the shift, the nurse notices continuous bubbling in the suction chamber. The nurse correctly interprets this to mean:

Which signs and symptoms are characteristic of tension pneumothorax?

The nurse knows that an increase in negative pressure inside the pleural space will result in:

Development of sudden subcutaneous emphysema and a crunching or crackling sound associated with auscultation of the apical heart rate is indicative of: