Pneumothorax

General appearance

• diaphoresis

• cyanosis

• tracheal/mediastinal shift away from affected side

• bruising over affected area

Respiratory pattern

tachypnea, reduced movement on affected side

Breath sounds

diminished/absent on affected side

DCP

hyperresonant/tympanic over affected side

Vital signs

tachycardia, pulsus paradoxus, hypertension

Heart sounds

May be displaced

CXR

• hyperlucency

• absence of vascular markings on affected side

• tracheal shift to unaffected side

• depressed diaphragm

• lung collapse

Small pneumothorax (less than __% of lung collapsed) may only require ___ ___ and limited _____ ______. Absorption usually occurs within __ days

20%; bed rest; physical activity; 30

Larger pneumothorax (greater than __% of lung collapsed) should be evacuated by ___ ____.

20%; chest tube

What are signs a patient is unstable and what next step is necesary?

Bradycardia, hypotension, and cyanosis are signs of instability, the next step would be needle aspiration

What should be given for hypoxemia?

Oxygen

What should be ordered after chest tube insertion?

Hyperinflation therapy (IS/SMI,IPPB)

Mechanical ventilation with PEEP for?

Acute ventilatory failure