Respiratory Trauma for Certified Emergency Nursing (CEN)
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Included In This Lesson
Study Tools For Respiratory Trauma for Certified Emergency Nursing (CEN)
Tension Pneumothorax (Image)
Atelectasis Pathochart (Cheatsheet)
Atelectasis (Image)
Example Care Plan_Pneumothorax/Hemothorax (Cheatsheet)
Left Hemothorax Xray (Image)
ARDS Pathochart (Cheatsheet)
ARDS Ventilation (Cheatsheet)
CT Scan Pulmonary Contusions (Image)
Pulmonary edema treatment (Mnemonic)
Outline
Respiratory Trauma
Definition/Etiology:
Blunt, penetrating and blast trauma can all cause swelling of lung tissue and compromised gas exchange (pulmonary contusion, edema, and ARDS).
Mechanical problems compromising lung filling:
- Fracture of chest wall bones (flail segment)
- Hemothorax
- Pneumothorax
- Tension pneumothorax
Pathophysiology:
Compression of lung / alveoli from tension pneumothorax / atelectasis / hemothorax.
Compromised gas exchange from pulmonary edema / ARDS / pulmonary contusion.
Blast injury–
- Primary: blast wave of air damages alveoli
- Secondary: shrapnel hits chest
- Tertiary: chest wall can hit stationary objects
Clinical Presentation:
- Dyspnea
- Low oxygen saturation (can develop late)
- Crepitus
- Decreased lung sounds
- Abnormal movement of chest wall
- Deviated trachea
Collaborative Management:
- Supplemental oxygen for all
- Needle decompression if tension
- Flutter valve dressing if penetrating trauma
- Chest thoracostomy tube if hemo and/or pneumo
- CXR/CT
- Collaborate with respiratory therapy
- Arterial blood gasses
Evaluation | Patient Monitoring | Education:
- Continuous oxygen saturation
- Monitor output of chest tube
- Continuous cardiac monitoring
- Be alert for late changes of pulmonary edema and ARDS
Linchpins: (Key Points)
- Gas exchange is the goal
- Understand P:F ratio
- Watch for development of tension
- Late edema / ARDS can occur
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Legome, E. (2022, September 28). Initial evaluation and management of blunt thoracic trauma in adults. UpToDate. https://www.uptodate.com/contents/initial-evaluation-and-management-of-blunt-thoracic-trauma-in-adults
- Winkle, J. M. (2022, September 29). Initial evaluation and management of penetrating thoracic trauma in adults. UpToDate. https://www.uptodate.com/contents/initial-evaluation-and-management-of-penetrating-thoracic-trauma-in-adults
- American Academy of Pediatrics. (2021, November 1). Blast terrorism and explosions: disaster management resources. https://www.aap.org/en/patient-care/disasters-and-children/disaster-management-resources-by-topic/blast-terrorism-and-explosions/
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Concepts Covered:
- Concepts of Population Health
- Respiratory System
- Noninfectious Respiratory Disorder
- Emergency Care of the Trauma Patient
- Respiratory Emergencies
- Medication Administration
- Liver & Gallbladder Disorders
- Cardiac Disorders
- Infectious Respiratory Disorder
- Disorders of Pancreas
- Concepts of Pharmacology
- Communication
- Neurological Emergencies
- Respiratory Disorders
- Oncology Disorders
- Upper GI Disorders
- Vascular Disorders
- Labor Complications
- Psychotic Disorders
- Acute & Chronic Renal Disorders
- Emergency Care of the Cardiac Patient
- Central Nervous System Disorders – Brain
- EENT Disorders
- Legal and Ethical Issues
- Childhood Growth and Development
- Concepts of Mental Health
- Substance Abuse Disorders
- Prenatal Concepts
- Newborn Complications
- Endocrine and Metabolic Disorders
- Nervous System
- Delegation
- Perioperative Nursing Roles
- Neurological Trauma
- Musculoskeletal Trauma
Study Plan Lessons
Disasters & Bioterrorism
Respiratory Structure & Function
COPD (Chronic Obstructive Pulmonary Disease) Labs
Respiratory Trauma for Certified Emergency Nursing (CEN)
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
IV Push Medications
Esophageal Varices for Certified Emergency Nursing (CEN)
Heart Failure 2 – Live Tutoring Archive
Anti-Infective – Antitubercular
Antidiabetic Agents
Pharmacodynamics
Patients with Communication Difficulties
NG Tube Medication Administration
Acute Bronchitis
Brain Tumors
CT & MR Angiography
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Streptokinase (Streptase) Nursing Considerations
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Aortic Aneurysm
Preterm Labor
Lung Surfactant for Newborns
Premature Rupture of the Membranes (PROM)
Antipsychotics
Types of Schizophrenia
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Supraventricular Tachycardia (SVT)
Ventricular Fibrillation (V Fib)
Pain and Nonpharmacological Comfort Measures
Migraines
Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Tonsillitis
HIPAA
Growth & Development – School Age- Adolescent
Defense Mechanisms
Nursing Care Plan (NCP) for Alcohol Withdrawal Syndrome / Delirium Tremens
Discomforts of Pregnancy
Giving Handoff Report
Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)
Nursing Care Plan (NCP) for Dehydration & Fever
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
Spinal Cord
Accountability and Assistance for Personal Limitations for Certified Perioperative Nurse (CNOR)
Delegation and Personnel Management for Certified Perioperative Nurse (CNOR)
Atrial Flutter
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Sinus Tachycardia
Neurological Fractures
1st Degree AV Heart Block
3rd Degree AV Heart Block (Complete Heart Block)
Fractures
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)