Symptoms And Treatment Of Child Bearing Age

Symptoms And Treatment Of Child Bearing Age
Lymphangioleiomyomatosis (LAM) affects the lungs, kidneys and lymphatic system primarily in
women of child bearing age. (Genetics Home Reference Staff) This disease is so rare that statistics
do not accurately reflect how many women or persons suffer from LAM. Those that suffer from
LAM are offered varied treatments that assist in alleviating symptoms but there is no cure for this
lung disease. The origins of LAM are unknown and researchers are working to determine the
pathology of the condition. Women are primarily impacted during childbearing years. Symptoms are
normally noted after puberty and before menopause. (Reviewed by Jennifer Robinson) Additionally,
increased hormones during pregnancy can exacerbate symptoms. (National Institutes of Health
Staff) Less than ten males have been clinically diagnosed with LAM. (Reviewed by Jennifer
Robinson) This sickness causes cells that edge the airways in the lungs and blood vessels to multiply
abnormally in the muscles that line the airways in the lungs and blood vessels. These muscle cells
aggressively spread into areas of the lung where they don 't belong. (Reviewed by Jennifer
Robinson) These abnormal cells start to develop out of control throughout the bodies organs and
tissues, specifically the lungs, and lymphatic system. (National Institutes of Health Staff) The lungs
air sacs swell creating small cysts. These cysts inhibit breathing and oxygen becomes limited
throughout the body. TSC is a genetic disease. The
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Metabolic Pattern Paper
Nutrition–Metabolic Pattern:
Subjective
V.S said that she has a "good appetite, but could follow a more nutrient rich diet." During a 24 hour
diet recall, she described a normal breakfast as toast and coffee, and supper as a sandwich or pasta.
She doesn't eat lunch normally, but admitted to "chronic snacking, and a sweet tooth". Her typical
fluid intake is 16 ounces of water, and two cups of coffee. She denied any changes in appetite, and
doesn't have pain with chewing/ swallowing, or any diet restrictions. Her weight "fluctuates a lot,"
and she is 5 feet 4 inches. V.S wears dentures and doesn't regularly visit the dentist. Her most recent
lab values were all normal. Objective
V.S's actual height and weight was 5'4'', 174 lbs. Her BMI is ... Show more content on
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Impaired Gas Exchange R/T lobectomy, AEB SOB.
Chronic (nerve) pain R/T lobectomy, AEB subjective reports of chest pain exasperated by the cold.
Sleep and Rest Patterns:
Subjective:
V.S said that she gets an adequate amount of sleep (10 hours), but has a lot of difficulty remaining
asleep; she wakes up numerous times a night. Her room is very dark, warm, and quiet. She takes
Ativan for her insomnia, and it helps, but she still doesn't feel rested after a full night of sleep. She
never has caffeine before bed. Objective
V.S looked very tired during the interview; the interview was conducted around noon. She had dark,
prominent circles under her eyes, and yawned twice. The environment of the interview and
assessment was her home; it was warm, quiet, and had adequate lighting. Possible Diagnosis
Insomnia and sleep deprivation, R/T sleeping patterns, AEB objective reports of difficulty falling
and staying asleep, and dark circles under the

Respiratory Essay
Case Study for Respiratory Disorders #2
Scenario
A.W., a 52–year–old woman disabled from severe emphysema, was walking at a mall when she
suddenly grabbed her right side and gasped, "Oh, something just popped." A.W. whispered to her
walking companion, "I can't get any air." Her companion yelled for someone to call 911 and helped
her to the nearest bench. By the time the rescue unit arrived, A.W. was stuporous and in severe
respiratory distress. She was intubated, an IV of lactated Ringer's (LR) to KVO (keep vein open)
was started, and she was transported to the nearest emergency department (ED).
On arrival at the ED, the physician auscultates mufﬂed heart tones, no breath sounds on the right,
and faint sounds on the left. A.W. is ... Show more content on Helpwriting.net ...
You also note that on the cardiac monitor A.W. is having numerous irregular beats.
6) Which one of these lab test results most concerns you? Explain.
BUN elevation can be caused by impaired renal secretion that could cause shock.
7) What is causing the irregular beats on the cardiac monitor?
She could possibly be going into shock because of elevated BUN levels.
As the physician begins the process to insert the chest tube the mechanical ventilator suddenly fails.
8) What should you do?
I would tell the doctor to stop if he didn't start and grab a manual ventilator and try to find a
replacement mechanical ventilator.
A.W.'s chest tube is inserted successfully and she is stabilized. She is admitted to the ICU and will
be in the hospital on bed rest for a minimum of several days as she recovers.
9) What is the number one complication you want to guard against for A.W.? Explain.
Pneumonia, because she isn't mobile.
10) What can you do to prevent this complication?
Have AW use an incentive speromiter to help with deep breathing.
Three days after admission A.W. is diagnosed with a pulmonary embolism.
11) List six assessment ﬁndings you should monitor closely for with this condition.
I would carefully monitor vital signs, cardiac dysrhythmias, pulse oximetry, ABG's and lung sounds.
12) Why did A.W. develop a

History and Physical Examination for Putul Barua Essay
CASE STUDY 3
HISTORY AND PHYSICAL EXAMINATION
Patient Name: Putul Barua
Patient ID: 135799
Room No.: CCU–4
Date of Admission: 01/07/2013
Admitting Physician: Simon Williams, MD
Admitting Diagnoses 1. Rule out myocardial infraction 2. History of tuberculosis. 3. Hemoptysis. 4.
Status post embolectomy.
CHIEF COMPLAINT: Tightness in the chest, shortness of breath, fast heart rate.
HISTORY OF PRESENT ILLNESS: Mr. Barua is a 42–year–old gentleman from Bangladesh who
presents with chest tightness, shortness of breath, and tachycardia. Dr. J.K. McClain of cardiology is
evaluating his heart condition. The patient has had the recent onset of hemoptysis. He was treated
for tuberculosis in Bangladesh 15 ... Show more content on Helpwriting.net ...
PHYSICAL EXAMINATION: Vital signs are WNL. Apparently he has had no chills, night sweats,
or favors. Generalized malaise and a lack of energy have been the main concerns. HEART: Regular
rate and rhythm with S1 and S2. No S3 or S4 is heard at this time. LUNGS: Bilateral rhonchi. No
significant amphoric sounds are noted. ABDOMON: Soft nontender. No hepatosplenomegaly or
masses are detected. RECTAL EXAM: Prostate smooth and firm. No stool is present for hemoccult
test.
DIAGNOSIS: Hemoptysis with history of tuberculosis.
PLAN: I have reviewed the chest x–rays available here and agree with the finding of bleb formation
in the right and left upper lobes. Despite the fact that the patient has had a high INR, because of his
history of tuberculosis and hemoptysis I believe obtaining sputum for TB is very, very important.

We should rule out any other endobronchial lesions as the cause for his bleeding. I have discussed
this matter with the patient and his wife. I have told them that there is the possibility of observing
the condition by x–rays and repeated tests of his sputum. They understand that this is an option;
however, they decided that because of concern regarding his repeated hemoptysis, they would
consent to bronchoscopy. We will arrange for the patient to have a bronchoscopy done. He is off
Coumadin.
(Continued)
HISTORY AND PHYSICAL EXAMINATION
Patient Name: Putul Barua
Patient ID: 135799
Date of Admission: 01/07/2013

Cerebral Air Embolism Following Pigtail Catheter Insertion
Cerebral air embolism following pigtail catheter insertion
Abstract:
Pleural pigtail catheter placement associated with many complications including pneumothorax,
hemorrhage, and chest pain. Air embolism can rarely be a complication of pigtail catheter insertion
and has a high risk of occurrence with positive pressure ventilation (PPV).
Cerebral air embolism is a very rare complication but lethal. We report a case of patient of cerebral
air embolism as a complication of placement of pigtail pleural catheter placement while a patient on
(PPV).
Case presentation:
A 50 years old male who has bilateral pneumonia, was found to have pneumothorax while on
mechanical ventilation CPAP/PS mode. While placing the pigtail catheter, the patient ... Show more
content on Helpwriting.net ...
Keywords:
Cerebral air embolism–Pigtail catheter–Pneumothorax– Chest Tube
Introduction:
Placement of a chest tube indicated for pleural effusion and pneumothorax. There have been two
kinds of chest tubes being used, including a Pigtail catheter and chest tube thoracotomy.
The pigtail catheter drainage is widely used as it is easier and less invasive
Cerebral air embolism is a rare complication that can be induced by pulmonary barotrauma, the
trauma of the chest or head and iatrogenic causes such as invasive procedures or surgery. This risk
increases if the patient is on positive pressure ventilation and while the pressure in the airway
increased.
We reporting a case of cerebral air embolism associated with pigtail catheter insertion for treatment
of pneumothorax in a patient who was on positive pressure mechanical ventilation.
Case Report:
This is a 50 years old male with no significant past medical history presented initially with shortness
of breath and hypoxia and was transferred to the ICU. He was treated for bilateral pneumonia that
required prolonged mechanical ventilation via a tracheostomy. He has necrotizing pneumonia and he
has been in the hospital for 6 weeks due to the development of multi–organ failure. He was weaned
from mechanical ventilation to the point he was tolerating a CPAP/PS mode. Later on, it was noticed
that he

Symptoms And Treatment Of Congenital Pulmonary Alveolar...
demonstrated the histopathology of congenital pulmonary alveolar proteinases (PAP), CPI, DIP and
nonspecific interstitial pneumonia (NSIP). The lung biopsies from a sibling pair with DIP and
ABCA3 mutations likewise showed distinctly unusual lung growth that is characteristic of a diffuse
development disorder. All cases existed in term infants, with 66% presenting during childbirth with
tachypnea and hypoxia (Gail H.et al, 2007).
The genetic analysis, lung biopsy methods particularly in new children as little as 3 kg, (Robin R
.Deterding. 2010). And the new clinical as well pathological classification framework for diffuse
lung diseases in children have enhanced diagnostic capacities and modified the diagnostic standards
in chILD (Claire ... Show more content on Helpwriting.net ...
Ultimately, in 1990, the United States Food and Drug Administration (FDA) approved the use of
surfactants in neonates. Since then, surfactant therapy is considered as one of the few treatments that
has reduced general mortality in preterm newborns with RDS. On the basis of production, surfactant
is divided into two types: natural and synthetic (Roger Soll et al. 2001). The meta–analysis of
number of smaller studies comparing synthetic and natural surfactants have shown that synthetic
surfactants with their slower response might be supported for prophylaxis use, whereas natural
surfactants with their fast response might be more suitable for very sick infants at danger of
barotraumas and pulmonary air leaks (Richard A et al,2014). A meta–analysis comparing the
effectiveness of prophylactic vs. selective exogenous surfactant administration, carried out by
Rojas–Reyes et al., 2012 showed that prophylactic administration reduces the rate of pneumothorax,
pneumonic interstitial emphysema, neonatal mortality and death to more marked extent than specific
treatment (Rojas–Reyes et al., 2012). Comparing the meta–analysis of six randomized controlled
trails (RCTs) on the benefits of early (< 2 hours) and delayed (> 2 hours) surfactant administration,
(Richard playka et al., 2002). It has been deduced that early selective surfactant administration to
infants with RDS requiring assisted ventilation leads to a reduced risk of acute pulmonary injury and
a decreased risk of

Essay on Pneumothorax
1. Given the diagnosis of pneumothorax, explain why the paramedic had difficulty ventilating A.W.
Air escaped from the lung into the pleural space. Eventually, enough air collected in the pleural
space to cause the mediastinum to shift twoard the right. The collapsed left lung, increased
intrapleural pressure, and rightward shift make it difficult to ventilate A.W.
2. Interpret A.W.'s ABG's
Significant respiratory acidosis with profound hypoxemia. A.W. is near death.
3. What is the reason for A.W.'s ABG results?
70% of her right lung is collapsed and is not taking part in gas exchange
4. The physician needs to insert a chest tube. What are your responsibilities as the nurse?
Preinsertion:
Support patient with ... Show more content on Helpwriting.net ...
As the nurse, it is your responsibility to ensure pain control. In A.W.s case, would you administer
pain medication before the chest tube insertion?
The client is stuporous on arrival to the emergency room and is in a medical emergency; you may or
may not have time to administer pain medication. Preparing the chest tube set–up takes priority
because your client is near death and this is what will reverse her grave situation. If you do have
time after set–up or have other nurses helping you –– the quickest and fastest would be IV
administration – it is a common order to administer morphine 2– 6 mg IV titrated (example: 2 mg at
a time assessing each dose after approximately 5 minutes to see how the patient is doing; then
giving 2 mg more, waiting, assessing; etc until pain relief is observed)
6. The ER physician inserts a size 32 chest tube in the 2nd intercostal space, midclavicular line.
Many chest tubes are inserted in the 6th intercostal space, midaxillary line. What factor determines
where a chest tube is placed?

Medsurge 867 Case Study Questions And Answers
Discuss the following: medsurge 867
1. What is the purpose of a chest tube? Why does this patient need a chest tube?
Chest tubes are used to drain fluid or remove air from the patient's chest area. My patient had a chest
tube to drain his pleural effusion 26mL
2. How will you assess that the chest tube is functioning properly?
The tube is working properly if there are no leaks or air bubbles in the system. The drainage starts
flowing rather quickly and eventually tapers off over time once the fluid has been drained
completely.
3. What findings would indicate that the patient is ready to have the chest tube removed?
The chest tube will not have any more drainage coming from it for fluids and when the lung is re–
expanded in the case of a collapsed lung via ... Show more content on Helpwriting.net ...
ALWAYS keep the system below the chest level of the patient
Maintain suction at prescribed rate
Keep air vent open when suction is off
Throughout the placement of a chest tube, the patient should be assessed for complications of chest
tube drainage and for re–expansion of the lung. A nurse should assess the lungs and the thorax for
tracheal deviation, nonsymmetrical movement of the chest, emphysema, changes in the pattern of
breathing, adventitious lung sounds, and presence of a pneumothorax (tympany).
5. What is meant by the terms: "pleural effusions"? pneumothorax? tension pneumothorax?
Pleural effusion is the accumulation of fluid in the pleural space. This may lead to the accumulation
of fibrous tissue and the fluid will move towards the dependant area and collapse the adjacent lung.
Pneumothorax is the presence of air in the pleural space:
1. Traumatic pneumothorax occurs when air accumulates from a penetrating wound to the chest

Hesi Practice
Practice Examination For HESI exit Part One You will have two hours and 30 minutes to complete
Part One. 1. Which of the following describes a preterm neonate? A. A neonate weighing less than
2,500 g (5 lb, 8 oz). B. A low–birth–weight neonate. C. A neonate born at less than 37 weeks '
gestation regardless of weight. D. A neonate diagnosed with intrauterine growth retardation. 2. A
client with type 1 (insulin–dependent) diabetes mellitus has just learned she 's pregnant. The nurse is
teaching her about insulin requirements during pregnancy. Which guideline should the nurse
provide? A. "Insulin requirements don 't change during pregnancy. Continue your current regimen. "
B. "Insulin requirements usually decrease during the last two ... Show more content on
Helpwriting.net ...
B. heart rate greater than 100 beats/minute C. hyperventilation. D. respiratory rate greater than 20
breaths/minute 13. A client who has cervical cancer is scheduled to undergo
internal radiation. In teaching the client about the procedure, the nurse would be most accurate in
telling the client A. she 'll be in a private room with unrestricted activities. B. a bowel–cleansing
procedure will precede radioactive implantation. C. she 'll be expected to use a bedpan for urination.
D. the preferred positioning in bed will be semi–Fowler 's. 14. Before administering a tube feeding
to a toddler, which of the following methods should the nurse use to check the placement of a
nasogastric (NG) tube? A. Abdominal X–rays. B. Injection of a small amount of air while listening
with a stethoscope over the abdominal area. C. A check of the pH of fluid aspirated from the tube.
D. Visualization of the measurement mark on the tube made at the time of insertion. 15. While
assessing a 2–month–old child 's airway, the nurse finds that the child isn 't breathing. After two
unsuccessful attempts to establish an airway, the nurse should A. attempt rescue breaths. B. attempt
to reposition the airway a third time. C. administer five back blows. D. attempt to ventilate with a
handheld resuscitation bag. 16. Which of the following statements summarizes the underlying
principle for the development of a parenbchild relationship? A. The parents to–be had good role
models in their

The ABCD Rule: Detecting the Symptoms of Skin Cancer
1. Mary noticed a large, brown spot on her skin. She has been playing tennis in the sun for several
years without sun protection. She reported the discovery to a friend, who told her to apply the
ABCD rule to determine whether or not she had malignant melanoma. Her friend told her that if her
answer was "no" to the questions that were asked by the ABCD rule, she had nothing to worry
about. What is the ABCD rule and should she ignore the spot if her answers are negative?
My Mom had skin cancer, so I learned as much as I could about it. I knew the very basics from
working in the hospital but as a respiratory therapist my knowledge was limited. The ABCD rule is a
simple method by which an individual can screen themselves, friends and family ... Show more
It's main purpose is to prevent and or reduce friction between internal organs. It consists of two
layers the visceral which covers the outside of an organ and the parietal layer which lines a body
cavity. An example of this would be lungs. They have both a visceral and parietal layer and lining.
This allows for the lungs to expand and deflate with inhalation and exhalation. The serous
membrane of the lungs prevents them from creating friction with the heart and diaphragm. A good
example of a homeostatic imbalance of the serous membrane is a pneumothorax. There a different
types of pneumothorax' for my example I will use a traumatic pneumothorax, which could be the
result of being stabbed. Blood can fill up in the serous membrane of the lung which will cause it to
collapse, when this happens it becomes extremely difficult and painful for the patient to breath. If
left untreated it can be fatal, the patient go into respiratory failure and can bleed to death. A chest
tube needs to be inserted to allow the blood and or air to drain out thereby re–inflating the lung and
allowing the patient to breath. I have seen these when I worked in a trauma center, and have assisted
with the insertion of a chest tube it is not pretty and often done quickly. Serous membranes are vital
to life, and upsetting them or destroying them can lead to painful or even fatal consequences.
Cutaneous membranes are our "suits" they cover our

Pneumothorax Research Paper
The human body is processed and controlled by many different combinations of the systems of the
body. One of the main functioning systems of the body is the respiratory system. First breathing in
oxygen into your lungs your body then transports the oxygen into your blood and to the cells
through out the body then releasing the result of this gas exchange which would be carbon dioxide.
When functioning correctly the body will be able to distribute oxygen and eliminate carbon dioxide
without any hesitation. But very rarely something can go extremely wrong causing one of the main
parts of this cycle to fail, the lungs. This error in the human body is called a pneumothorax. A
pneumothorax is defined as a condition that occurs when air enters a ... Show more content on
Helpwriting.net ...
While these episodes happen completely randomly in a patients body "most happen while the
patient is at rest...Chest pain may be minimal or sever and, at onset, has been describes as "sharp"
and later as a "steady ache"...Symptoms usually resolve within 24 hours..."(Sahn, 2000). Not all
pneumothorax are debilitating and some may be so small that they are even unnoticeable during a
physical exam. Although pneumothorax in general are a rare occurrence primary spontaneous
pneumothorax are slightly more common in the population shown at a ratio of 18 to 100,000 in men
and 6 to 100,000 in women. Though these three categories break down pneumothorax into the most
common ways this event occurs it does not explain how there are diagnosed of

The Physiology Of The Lungs
Physiology of the Lungs There are several factors that oppose and promote alveolar collapse,
including the transmural pressure gradient, pulmonary surfactant, alveolar interdependence (all
opposing factors), alveolar surface tension and the elasticity of stretched pulmonary connective
tissue fibres (promoting factors). I will discuss these different aspects of lung physiology here.
Transmural Pressure Gradient and Elasticity of Stretched Pulmonary Connective Tissue Fibres
There are three important pressures involved in respiration. These are the atmospheric, intra–
alveolar and intrapleural pressures. The atmospheric pressure sits relatively constant at
approximately 760mmHg, and is simply the pressure exerted by the atmospheric air at sea level.1
The intra–alveolar pressure is the pressure within the alveoli, which varies in different stages of the
respiratory cycle, but eventually equates with the atmospheric pressure. Upon inspiration, the chest
wall expands outwardly and the diaphragm contracts downwards, pulling the lungs with them and so
forcing the alveoli open. The pressure within the alveoli falls and air enters the lungs down the
pressure gradient. On expiration, the diaphragm relaxes and the chest wall and stretched lungs will
recoil to their pre–inspiratory size due to their elastic properties. This recoil causes the intra–alveolar
pressure to rise and so air will leave the lungs following the pressure gradient until the intra–alveolar
pressure is equal to that of

Factors In Air-Breathing Vertebrates
In air–breathing vertebrates, the tidal volume of the lungs is the amount of air normally inhaled,
while the lung capacity is the maximum amount of air inhaled. In this experiment, a round balloon is
utilized to measure both the tidal volume and the lung capacity. Furthermore, students explored
possible factors impacting the vital capacity. Students established that body position is one factor
that has an impact on vital capacity. In this case, a standing position versus a seated position,
provides more room for the expansion of the chest cavity, thus allowing more air to be inhaled,
resulting in increased lung capacity.
Keywords: vertebrates, tidal volume, lungs, lung capacity, factors, impact, position, expansion
Introduction
In air–breathing vertebrates, the lungs are "two large organs of respiration located in the chest cavity
and responsible for adding oxygen to and removing carbon dioxide from the blood" (Encyclopædia
Britannica, 1) The lungs expand and contract with each breath, and the amount of air moving in and
out of the lungs can vary. A diagram of the lungs is represented in the appendix Diagram, labeled as
Figure 1. To establish the amount of air inhaled, lung capacity needs to be established. Lung
capacity can be measured either using a spirometer (Encyclopædia Britannica, 1) or simply by using
a round balloon. The amount of air inhaled in a single breath is called the tidal volume. "In the
average adult, tidal volume is about 0.5 liters. However, the lungs

Essay on Nclex Rn Questions Chapter 58
Chapter 58
Practice Questions page 755 (652–674)
(652) 1. An emergency department nurse is assessing a client who has sustained a blunt injury to the
chest wall. Which of these signs would indicate the presence of a pneumothorax in this client? *
Diminished breath sounds
Rationale: This client has sustained a blunt or a closed chest injury. Basic symptoms of a closed
pneumothorax are shortness of breath and chest pain. A larger pneumothorax may cause tachypnea,
cyanosis, diminished breath sounds, and subcutaneous emphysema. Hyperresonance also may occur
on the affected side. A sucking sound at the site of injury would be noted with an open chest injury.
(653) 2. A nurse is caring for a client hospitalized with acute ... Show more content on
Helpwriting.net ...
If side effects develop, especially cardiac irregularities, the procedure is stopped and the client is
reoxygenated. * * (659) 8. A nurse is assessing the respiratory status of a client who has suffered a
fractured rib. The nurse would expect to note which of the following? * Pain, especially with
inspiration * Rationale: Rib fractures are a common injury, especially in the older client, and result
from a blunt injury or a fall. Typical signs and symptoms include pain and tenderness localized at
the fracture site and exacerbated by inspiration and palpation, shallow respirations, splinting or
guarding the chest protectively to minimize chest movement, and possible bruising at the fracture
site. Paradoxical respirations are seen with flail chest. * * (660) 9. A client with a chest injury has
suffered flail chest. A nurse assesses the client for which most distinctive sign of flail chest? *
Paradoxical chest movement * Rationale: Flail chest results from multiple rib fractures. This results
in a "floating" section of the ribs. Because this section is unattached to the rest of the bony rib cage,
this segment results in paradoxical chest movement. This means that the force of inspiration pulls
the fractured segment inward, while the rest of the chest expands. Similarly, during exhalation, the
segment balloons outward while the rest of the chest moves inward. This is a

A Short Note On Emphysema And Pneumomediastinum : The...
Mediastinal emphysema or pneumomediastinum is the presence of air or other gases within the
confines of mediastinal structures. First described by Laennec in 1819 [1], the main causes of
pneumomediastinum are trauma, tracheobronchial or oesophageal–bronchial fistulas, invasive
procedures (cervical, thoracic, or abdominal), positive–pressure ventilation, coughing, vomiting,
Valsalva manoeuvre, physical exertion, and inhaled drug use, among others [2]. It rarely occurs in
the absence of pulmonary disease or other precipitating factors. In this case, it is referred to as
spontaneous pneumomediastinum (SPM) [3]. SPM is rare in adults, with young male individuals
being the most frequently affected, with a male/female ratio of 8 to 1 [2].
A ... Show more content on Helpwriting.net ...
Although phenotypic features and deletion sizes are variable, deletion of 16q22 appears to be critical
for manifestations of the syndrome [5]. A review of published reports of 7 patients with different
deletions of regions 16q21 to 16q24, including 1 patient with a 16q13–q22 deletion, and noted that
there was a constellation of similar features [5]. The most common features exhibited by the
affected individuals were low birth weight, hypotonia, feeding disturbances, failure to thrive, and
delayed psychomotor development. The characteristic dysmorphic features included prominent
forehead, wide anterior fontanel, diastasis of cranial sutures, blepharostenosis, hypertelorism, broad
nasal bridge, low–set and deformed ears, and short neck while narrow thorax and ectopic anus were
less commonly seen. The most common deleted region was 16q22 [5]. SPM is not a recognised
feature of this syndrome.
She was on daily oral doses of Tacrolimus 1gm, Prednisone 7.5 mg, Acyclovir800mg, Variconazole
400mg, Bactrim (800mg/160mg) thrice a week and Thyroxine 75mcg. She was allergic to
Amoxycillin and Naproxen.
She lived with her mother, was a non–smoker and denied any illicit or recreational drug use.
On the initial presentation to Emergency department with worsening dyspnoea, dry cough and neck
tightness. The patient was afebrile, acyanotic, tachypnoiec (respiratory rate of 36 per minute),
tachycardic (heart rate of 166 per

A Short Note On Pulmonary Diseases And Conditions
Lymphangioleiomyomatosis (LAM)
Pulmonary diseases and conditions have been present since the lungs were discovered by ancient
doctors. From tuberculosis to COPD, our lungs are highly susceptible to illness. What causes these
illnesses? Oftentimes, it's environmental. The infectious particles in the air we breathe or materials
we purposely inhale, ie. cigarettes, that make it through our bodies' filters cause many of these
problems. But for diseases like LAM, the cause is genetic.
LAM is a rare lung disease characterized by abnormal growth of smooth muscle cells, especially in
the lungs, lymphatic system, and kidneys. There are two forms of LAM, Sporadic LAM (S–LAM)
and Tuberous Sclerosis LAM (TSC–LAM). The first type occurs for unknown ... Show more
One of these is pneumothorax, or collapsed lung. This can occur if the cysts rupture through the
lining of an affected lung. The air that collects in the space between the lung and chest wall must be
removed in order for the lung to be reinflated. Pleural effusions may also occur. This is where bodily
fluids collect in the space between the lung and chest wall, and it can often cause shortness of breath
due to the restricted room to expand. Many later sym ptoms emerge due to spreading of the tumors
into other areas of the body. Sufferers may also experience blood in the urine due to the tumors
spreading to the kidneys. Areas of the body may also begin to swell, such as the abdomen, legs,
ankles, and feet. Many of these symptoms result in hospital visits, where sufferers are eventually
diagnosed. But how is LAM diagnosed? Because this disease manifests in many different ways, it is
sometimes difficult to diagnose. Sometimes, the difficulty of diagnosis is compounded by the fact
that many of LAM's symptoms are similar to other pulmonary diseases, such as asthma,
emphysema, and bronchitis. Chest x–rays aren't always sufficient to detect LAM, but chest CT scans
can often detect the cystic structure of this disease. These scans often provide an accurate diagnosis,
especially if other manifestations of the disease (e.g., benign tumors, fluid in the lungs, or even a
collapsed lung) are present in the patient. In some circumstances, a lung biopsy is needed to provide
the

When Should You Go To A Hospital Essay
When Should You Go To A Hospital? Something's wrong. You're sick, and you need medical
attention. Not urgently? Maybe the pain in your chest will go away. Maybe your finger will stop
bleeding. Maybe if you went to the hospital you'd end up waiting for hours. Then again things might
worsen if you stay at home. We all face this choice at one time or another. And the decision is
complicated by the fact that most of us, no matter how sick we feel, would rather stay at home than
visit a hospital. Perhaps you're concerned you'll only add to the burden on the hospital staff, or that,
they'll make fun of you for having panicked and rushed to them for nothing. The most important
factor in deciding whether to go to a hospital or to crawl into bed is your health. You ... Show more
Mental infirmity is involved. If a person has a history of mental illness such as schizophrenia,
depression or manic depression and has become terrifying in some way, or unsafe to himself or
others, a hospital is the place to go. Also, if someone is using drugs and his behaviour drastically
changes or he looks unwell due to health changes, he may need emergency care. Hospital
emergency staff are trained to deal with crises, calm people and prevent suicides. Although it may
be unnecessary, but if you still feel that your symptoms require the attention of an experienced
doctor or trained staff at the hospital, do not hesitate to go and get yourself checked out. Ultimately,
it is up to you to decide whether to go to the hospital or not. The doctors are always there to help out
and that is why hospitals run an emergency service 24/7. So, if you are worried, don't hesitate and
just make that trip to the hospital, for mental satisfaction and peace, if not anything else. Equipped
with these five reasons which determine if one really needs medical attention, you can rest at peace
in the knowledge that your symptoms may be temporary and harmless or whether you do require to
make that trip to the emergency

Bhd Syndrome Essay
1.1 Birt–Hogg–Dubé Syndrome
Birt–Hogg–Dubé (BHD) syndrome (OMIM 135150) is a rare, autosomal dominant, hamartoma
disorder which is characterized by benign tumours of the hair follicle (fibrofolliculomas), lung cysts
and pneumothorax (collapsed lung), and renal neoplasia. BHD was first described in 1977 by three
Canadian doctors – Birt, Hogg and Dubé (Birt et al. 1977). The syndrome had also been identified
1975 by Hornstein and Knickenberg (Hornstein & Knickenberg 1975) and there has been suggestion
of renaming the disease to Hornstein–Birt–Hogg–Dubé, however due to confusion this name was
never used.
A genome–wide linkage analysis using polymorphic microsatellite markers on a large Swedish
family in 2001 mapped the BHD–associated locus to ... Show more content on Helpwriting.net ...
in a study of 152 patients from 49 families in 1999 first described the presence of pulmonary cysts
in BHD patients (Toro et al. 1999). Most of BHD patients are likely to develop pulmonary cysts and
are susceptible to recurrent spontaneous pneumothorax. The study of 50 BHD families showed 88%
of the families developed pulmonary cysts and 53% of the families had a history of pneumothorax.
In another study, Toro et al. reported a 93% pulmonary cyst presence in BHD patients (Toro et al.
2007)(Toro et al. 2008). Pulmonary cysts are the most common BHD manifestation, seen in up to 90
% of patients (Predina et al. 2011). It has been suggested that the number of pulmonary cysts
correlates with episodes of spontaneous pneumothoraces. Zbar et al. identified an increase in the risk
of pneumothorax for BHD–affected individuals, which they postulated to be due to the presence of
pulmonary cysts (Zbar et al.

Pneumothorax Essay
The greatest advantage of fine needle aspiration is safety. Fatal complications like systemic air
embolism , haemorrhage or pericardial tamponade have been described. However, pneumothorax
remains the most common complication of CT–guided lung FNAC. Review of the existing literature
reveals variable rates of pneumothorax, ranging from 5 to 64% . Pneumothorax was noted in 36.2%
patients of my study population. In three patients (5.2%) moderate pneumothorax was seen
requiring chest tube placement. It was found that the amount of lung traversed by the needle & size
of the lesion is significantly associated with development of pneumothorax. The more the amount of
the lung tissue traversed by the lesion the more was the complication rate and the ... Show more
Size of the lung masses of inadequate sample groups (37.7±5.3) were significantly smaller
statistically (p value=0.01) compared to the group where sample was adequate (54.69±3.49). This is
in agreement with the study by Guimarães et al In this study, lesions with diameters equal to or
larger than 40 mm supplied larger amounts of adequate material for analysis than lesions with
diameters of less than 40 mm. This study also stated that the superior lobe lesions supplied a
proportionally larger amount of adequate material for analysis when compared with other locations.
However this finding was not noted in my study. Layfield et al. reported that the location of thoracic
lesions affect the sample adequacy of CT guided FNAC of the lung lesions, with peripheral and
larger lesions providing more adequate sample. However Yankelevitz et al. & Guimarães et al23
both showed that the distance between the lesion and the pleural surface did not influence the
probability of obtaining adequate sample. In my study also, there was no statistically significant
difference in obtaining adequate material between the peripheral and deep seated

Physical Reflection : The Embryology Of The Pleura
Embryology of the pleura
Derivation all body cavities from the coelom derived from primitive mesoderm and lined with
mesothelium – same origin as pericardium and peritoneum – all at risk from primary mesothelioma
Surface anatomy of the pleura
The surface marking of the lung represents the markings of the visceral pleura. The apex of the lung
extends convexly upwards to a distance of approximately 2.5 cm above the junction of the medial
and intermediate thirds of the clavicle. The anterior border of the right lung descends from the
posterior aspect of the sternoclavicular joint, behind the sternal angle, to the level of the xiphisternal
joint. The left lung has a similar course until it reaches the level of the 4th or 5th intercostal space,
where it curves laterally beyond the lateral margin of the sternum to accommodate the cardiac notch.
After this, the anterior border of the left lung turns sharply to the level of the xiphisternal joint. The
lower lung border extends in mid–inspiration to the 6th rib in the mid–clavicular line, 8th rib in the
mid–axillary line and the 10th rib posteriorly adjacent to the vertebra.
Surface marking of the parietal pleura closely follows that of the lung. The apical extension of the
parietal pleura is almost identical to that of the visceral pleura, as only a thin film of fluid only
separates them. The anteromedial border of the pleura on the right is similar to that of the visceral
pleura. The left parietal pleura takes a course similar

Case Study Pleural Effusion
Case Study Pleural effusion NSG/340 Sandra Gilderson, MSN/Ed, RN Case Study Diagnosis and
admission A.B. admitting diagnosis pleural effusion, pulmonary infiltrates possible pneumonia
based on the result of chest x–ray. Also the presenting signs and symptom provided information that
can link to pleural effusion evidenced of his signs and symptoms Pleural effusion Is an abnormal
collection of fluid in the pleural space, it is not a disease but an indication of a disease (Lavie et al,
2014). Difference between transudate and exudate "A transudate effusion occurs primarily in
noninflammatory conditions and is an accumulation of protein–poor, cell–poor fluid" (Lavie et al,
2014, p. 549). The fluid is leaking into the pleural ... Show more content on Helpwriting.net ...
Consequences related to pleural effusion is the fluid located in the pleural cavity present as a space
that is occupying mass, which causes a decrease in the lung expansion. The decrease of the lung
expansion on that affected side is proportionate with the amount of fluid that is collected. This
therefore results to hypoxia, dyspnea, and pleuritic pain (Saguil et al., 2014). Pulmonary infiltrates is
an hypersensitivity reaction, lung infiltration, characterized by infiltration of the alveoli
(bronchoalveolar), with eosinophilia and large mononuclear cells, edema, extensive infiltrates in the
lung zones leading to inflammation of the lungs (Tzilas et al.,2009). From a pathophysiological
perspective, the term infiltrate" refers to an abnormal substance that accumulates gradually within
cells or body tissues or "any substance or type of cell that occurs within or spreads as through the
interstitium and/or alveoli of the lung, that is foreign to the lung parenchyma, or that accumulates in
greater than normal quantity within it. (Patterson et al., 2012). Consequences result in prolong
illness that accompany fever, cough, dyspnea, weight loss, possible pus, severe tissue reaction as in
certain drug allergies, pus, which can further lead to pneumonia that is

Essay about Lab Simulation Exercise 7: Respiratory System...
1.) When you forcefully exhale your entire expiratory reserve volume, any air remaining in your
lungs is called the residual volume (RV). Why is it impossible to further exhale the RV (that is,
where is this air volume trapped, and why is it trapped?)
This "dead space" of air needs to stay in your lungs constantly; otherwise the lung will completely
deflate. If the lung has every bit of air sucked out of it, it will collapse and need to be re–inflated.
2.) How do you measure a person's RV in a laboratory?
By the air remaining in the lung
3.) Draw a spirogram that depicts a person's volumes and capacities before and during a significant
cough.
Additional Questions for Activity 1.
The following questions ... Show more content on Helpwriting.net ...
Returned to normal were TV, ERV, FEV1 (%); smooth muscles in the bronchioles didn't return to
normal blue mucus still blocks the airway
6.) How much of an increase in FEV1 do you think is required to be considered significantly
improved by the medication?
10–15% improvement
7.) With moderate aerobic exercise, which changed more from normal breathing, the ERV or the
IRV? How well did the results compare with your prediction?
IRV changed more with moderate activity
8.) Compare the breathing rates during normal breathing, moderate exercise, and heavy exercise.
TV increased over normal breathing with both moderate and heavy exercise.
Activity 3. Effect of Surfactant and Intrapleural Pressure on Respiration
Chart 3: Effect of Surfactant and Intrapleural Pressure on Respiration
Surfactant

Intrapleural pressure left (atm)
Intrapleural pressure right (atm)
Airflow left
(ml.min)
Airflow right
(ml/min)
Total Airflow
(ml/min)
0
–4
–4
49.69
49.69
99.38
2
–4
–4
69.56
69.56
139.13
4
–4
–4
89.44
89.44
178.88
0
–4
–4
49.64
49.64
99.38
0
0.00
–4
0.00
49.64
49.69
0
0.00
–4
0.00
49.69
49.69
0
–4

–4
49.69
49.69
99.38
1.) Why is normal quiet breathing so difficult for premature infants?
They don't have much surfactant.
2.) Why does a pneumothorax frequently lad to atelectasis?
If the lungs are broken down mechanically, then the chances of developing

Essay on Pulmonary Diseases
Pulmonary Diseases Any disorder or disease that occurs in the lungs or causes the lungs not to
function correctly is referred to as lung disease. The three main types consist of lung tissue diseases,
airway diseases, and pulmonary circulation diseases. Lung tissue diseases involve the lung tissue
structure. When the tissue becomes inflamed and scarred, the lungs are no longer able to fully
expand, which is known as restrictive lung disease. In addition, it also causes the lungs to have more
difficulty taking in oxygen and releasing carbon dioxide. An example of lung tissue disease is
pulmonary fibrosis, which is sometimes described as a feeling of not being able to take a deep
breath. Airway diseases involve the tubes, or airways, that ... Show more content on Helpwriting.net
...
There are times when a lung will collapse when there is lung damage caused by diseases such as
cystic fibrosis, pneumonia, or asthma. A direct lung or chest injury is not always the cause. Lung
collapse is especially common when the lungs fill up with air sacs that form, due to emphysema, and
these air sacs are called blebs. The lung collapses when air is discharged into the pleural cavity after
one of the sacs splits open. It is also possible that an unprompted pneumothorax can develop in a
person who has no evident lung disease, although it is most frequent in men between 20 and 40
years of age who are tall and thin. It is also more frequent in smokers. In addition, an unprompted
pneumothorax can occur in some people who have no obvious lung disease but have blebs that may
burst ("Pneumothorax," 2008). It is common in most pneumothorax cases for some air to move in
and out through the lung or chest wall tear. However, if the air is only able to move into the chest
cavity and not out, a tension pneumothorax condition can happen. This is when a developing pocket
of air produces escalating pressure within the pleural cavity, and this, in turn, may cause total
collapse of the

Pleural Effusion Research Paper
What is pleural effusion
Pleural effusion is known as a build–up of fluid between the layers of tissue that line the lungs and
chest cavity.
Below is a picture of what the lungs will look like with the excess pleural effusion present:
http://www.medicinenet.com/pleural_effusion_fluid_in_the_chest_or_on_lung/article.htm
There is usually the presence of 10–20ml of pleural fluid, this is lower in protein ( 15% above the
cutoff levels for Light's criteria.
ULN = upper limit of normal.
Data modified from Light RW: Pleural effusion. New England Journal of Medicine 346:1971–1977,
2002.
Whether a transudative pleural effusion is unilateral or bilateral it can be treated without extensive
evaluation, however exudative requires much investigation.
Other causes:
Cause Comments
Transudate
Heart failure ... Show more content on Helpwriting.net ...
Symptomatic effusions can be treated for reaccumulating or repeated effusions, by the process of
thoracentesis. The amount of fluid to be removed has no set limits, and the removal of fluid can
continue until the effusion is drained or the patient then develops chest tightness, chest pain, or
severe coughing.
For pleuritic pain NSAIDs can be given or other analgesics, on some occasions a short course of
oral opioids is given.
However effusions that are considered chronic, recurrent and causing symptoms is teated with
pleurodesis or intermittent drainage with an indwelling catheter. The effusions caused by cancer and
pneumonia however may require additional specific measures.
The actual prognosis however is mainly dependant upon the underlying disease. Complications may
present, these may be:
After thoracentesis there may be presence of air in the chest cavity (pneumothorax)
Lung

Hemothorax Research Paper
Hemothorax
A hemothorax is a collection of blood in the space between the chest wall and the lung. The medical
term for this space is the pleural cavity. It is also called the pleural space. The most common cause
for this condition is a chest injury. It can also happen from:
Diseases in the chest.
Blood clotting problems.
Taking blood thinning medicine.
Cancer of the chest.
Lung and heart surgeries.
Mild cases of hemothorax may clear without treatment in a couple weeks. More severe hemothorax
may require surgical treatment. Because the blood compresses the lung and takes up space, some of
the symptoms from this are:
Rapid, difficult breathing and shortness of breath.
Rapid heart rate, anxiety, and restlessness.

Blunt Force Trauma, Flail Chest, Heamoneumothorax,...
Blunt force trauma, Flail chest, Heamoneumothorax, Pulmonary contusion, Pericardial Tamponarde,
Shock, Respiratory shock, Hemoragic shock, and brake or fracture.
Steve is complaining of 8/10 pain on his left leg, it is clearly deformed, is a potential fracture or
dislocation. This is not a life threatening injury but a major distracting injury.
One of the patient's main injuries is the 12 cm contusion on his left axial/anterior chest with 8/10
pain.
When excessive blunt force trauma is applied to the chest wall above the body's tolerance the
musculoskeletal system protecting the vital organs will fail. "This blunt trauma can lead to fail chest
syndrome"...(Aaron MR at el 2001), pulmonary contusion, heamothorax or pneumothorax and ...
Show more content on Helpwriting.net ...
This leads to oedema, coagulation in alveolar spaces causing deficit of anatomical structure &
function. This injury can take up to 24 hours to develop eventually leading to poor perfusion,
increased pulmonary vascular resistance and decreased lung compliance. "50–60% of patients with
significant pulmonary contusions will develop bilateral Acute Respiratory Distress Syndrome
(ARDS)...(trauma.org 2004)"
Pulmonary contusions is hard to diagnose and can only be evaluated by the mechanism of injury
(MOI) , such as obvious signs of chest wall trauma such as contusion, fractures or flail chest.
"Crackles may be heard on auscultation but are rarely heard in the emergency room and are non–
specific."
This contusion involves injury to alveolar capillaries, resulting in accumulation of blood and fluids
within the lung tissue. This causes a V≉Q mismatch, increased intrapulmonary shunting, fluid shift
and segmental lung damage. Causing hypoxemia, hypercarbia and increases laboured breathing.
Blood loss of 150ml is usual for a single uncomplicated rib fracture. This amount of blood loss is
not life threatening on its own. If this blood enters the plural space it becomes a heamothorax.
Heamothorax can occur when bleeding penetrates into the pleural space. This can cause
hemodynamic and respiratory changes depending on the amount of blood loss. The pleural space
can hold 4 or more litters of blood causing shock. Due to the

A Short Note On The Air Leak Syndrome
Introduction
Air Leak Syndrome is a term used to describe a collection of similar pathologies related to air being
in pulmonary, pleural and interstitial spaces. The most common cause of air leak syndrome in
neonates is inadequate mechanical ventilation of their delicate lungs. The incidence of air leaks in
newborns is inversely related to the birth weight of the infants, especially in infants suffering from
respiratory distress syndrome and meconium aspiration (Walsh, 2015). Chest tube drainage and/or
needle aspiration are necessary in managing pneumopericardium with cardiac tamponade or tension
pneumothorax.
To prevent air leak syndrome, gentle ventilation with low pressure, low tidal volume, low
inspiratory time, high rate, and ... Show more content on Helpwriting.net ...
For pneumothorax, the incidence from 1990–2002 was 13% in babies weighing <1000 grams are at
high risk the first day or two after birth. Babies with pulmonary hypoplasia, meconium aspiration
syndrome, and respiratory distress syndrome are also at higher risk. Use of NIV/CPAP also
increases the risk. An article in the Pediatrics journal cited three cases where children of various
ages developed various air leaks from the use of high–flow nasal cannula (HHNC) therapy. The
author cited the urgent need to conduct more studies on HHNC and that it should not be used for
providing positive distending pressure. Set flows should not exceed the patient's minute ventilation
(Hegde, 2013).
Prevention
Sadly, it should be understood that most of pulmonary air leaks are iatrogenic. Healthcare workers
should not be overly aggressive when doing CPR and using the bag mask. Infants' lungs are fragile
and cannot handle being over–ventilated. When using mechanical ventilation, use low pressures low
tidal volumes and high respiratory rates. Risk of pneumothorax and pulmonary interstitial
emphysema can be reduced by using surfactant.
Pathophysiology
Air leaks are a result of overdistention of the lungs and can cause uneven alveolar ventilation and air
trapping. Increased pressures can rupture alveoli or other tissues, allowing air to escape into the
interstitial spaces. This air can then travel through perivascular adventitia, causing pulmonary
interstitial emphysema. If the air

Pneumothorax Case Studies
supported the use of large gauge(18g) needles since it required few passes, had similar complication
rates and equivalent diagnostic yield with that of smaller gauge needle(19.5 and 21g). Apart from
the needle size, several other factors have been found to influence the development as well as the
severity of post biopsy complications. A study conducted by Wang et al[48] concluded that smoking,
supine position and longer needle path within normal lung parenchyma were significant risk factors
for post biopsy pneumothorax. Eva Branden et al[8] observed that there was an increased risk for
pneumothorax when the biopsied lesion was small or when the emphysema was in the path of the
biopsy needle. Stanley et al[49] conducted a study to evaluate the diagnostic yield and
complications of CT guided thoracic biopsy. The study associated pneumothorax rate with traversed
lung length, lesion size and lesion depth. Risk factors influencing haemoptysis rate were found to be
the traversed lung length and lesion size. Analysis of risk factors affecting complications of CT ...
A similar observation was noted by Guimaraes et al[6] in their study that evaluated 362 biopsies. A
study conducted by Yeow et al[52] evaluating the risk factors for pneumothorax and bleeding
concluded that lesion depth was the most important predictor of post biopsy pneumothorax with the
highest incidence reported for subpleural lesions. Radiological evaluation of bronchogenic
carcinoma Bronchogenic carcinoma accounts for over 95% of all primary lung tumours[53]. It is the
leading cause of cancer deaths in both men and women worldwide accounting for approximately
27% of all cancer deaths[54]. This carcinoma is broadly divided into small cell lung carcinoma
(SCLC) and non small cell lung carcinoma (NSCLC). Histologically, NSCLC is sub classified

The Human Body, A Biological Organization Of Physiological...
Introduction The human body, a biological organization of physiological cascades, is surprisingly
fragile but yet highly adaptable to withstand the varying challenges encountered in the lifetime of an
individual. From chronic illnesses to acute and rapidly changing events, the integrated cooperation
between human organ systems can dramatically influence the potential outcomes of a patient. It is
multiple deployments of singular compensatory mechanisms in response to abnormal changes that
provides this infinite flexibility. While this continuous flexibility is illustrated in lifestyle diseases
such as hypertension and diabetes, its role in acute attention–demanding events are remarkable. An
example of such an attention–demanding occurrence ... Show more content on Helpwriting.net ...
Hemothoraxes, however, have also been documented to occur in cases of improper needle chest
decompression or catheter insertion, complication following thoracic surgery and various blood
disorders.
Cases of hemothoraxes have occurred in a range of ages from neonatal to geriatric, however, clinical
indications are often universal and only require simple imagery equipment in order to precisely
identify. While hemothoraxes are uncommon events in comparison to pneumothoraxes and the
presentation of some clinical signs and symptoms are similar. Clinical signs of tracheal deviation
oppose to the affected side and decrease auscultation of inferior lung sounds can indicate a medical
practitioner toward a pleural effusion but does not differentiate between hemothorax and
pneumothorax. The use of computed tomography and sonography, however, are the simplest and
most accurate methods to rapidly access the condition as the pooling of blood within the pulmonary
cavity is a distant contrast from normal.
The physiological stresses of hemothorax compared to pneunothorax on the human body differs
greatly for the cardiovascular system while is near identical for the respiratory system.
Cardiovascular System The complex cascades of cardiovascular events are directly linked to the
serve internal hemorrhaging of

Pneumothorax Scenario
In this scenario, the subjective data is as follows:
18–year–old male
Motor vehicle accident while drag racing, another car hit the driver side door of the car he was
driving.
Complaining of pain on the left side of his chest at an 8 out of 10 on the numeric pain scale,
especially when he tries to take a breath.
In this scenario the objective findings are as follows:
Heart rated elevated
Respirations elevated
Asymmetric expansion of the chest on inspiration
Coughing quite a bit
Lung sounds on the right side are clear
Lung sounds on the left side are diminished
With the subjective data and objective data, the patient could have one of the following three things
going on related to blunt force trauma:
Pneumothorax ... Show more content on Helpwriting.net ...
Nursing diagnosis for pneumothorax or hemothorax could include any of the following:
Impaired gas exchange related to decreased oxygen diffusion capacity
Ineffective breathing pattern related to decreased lung expansion
Risk of decreased cardiac output related to decreased preload (venous return)
Risk for infection related to chest tube insertion site and bacterial invasion
Risk for anxiety related to
Intervention can include any of the following:
Maintaining patient's airway, breathing and circulation
Most import intervention is re–inflating the lung by evacuating the pleural air or blood
Maintain a closed chest drainage system; tape all connections and secure tubing carefully at the
insertion site with adhesive bandages
Regulate suction according to the chest tube system directions; generally suction does not exceed 20
to 25cm H20 negative pressure
Use a sterile technique when changing the chest tube insertion site dressing
If the patient has a traumatic open pneumothorax it should be covered with a sterile occlusive
dressing because the occlusive dressing prevents are from escaping the lungs

Maintain aseptic technique, changing the chest tube insertion site dressing
Monitor tube insertion site for any signs of infection or

Musculoskeletal System Essay
The Department of Orthopedics (Musculoskeletal System)
We have a large aging population in town and recently new families with children have moved to
the area. We identify osteopenia (decrease in bone density, not as severe as osteoporosis) as early as
possible with routine checkups. At times we work closely with the nutritionist to ensure patients
have a good diet to support their bones including plenty of calcium and Vitamin D. Lately there
have been elderly patients who have missed several checkups and now have osteoporosis (weak
brittle bone) and are having fractures (partial or full break in bone), in which the radiologist
department performs an x–ray. Osteoclasia (intentional fracture of a bone) has been performed
before to correct a bone that healed incorrectly. An exceptional case of osteoma (new piece of bone
growing on bone, usually skull, is a benign tumor) required our lead orthopedic to perform
minimally invasive surgery.
We see several cases of herniated disc (damaged disc between vertebrae) and rheumatoid arthritis
(chronic inflammation affecting many joints). Myelograms (contrast dye used with x–ray and CT
scan) are performed to see if ... Show more content on Helpwriting.net ...
Patients have then developed pulmonary hypertension (high blood pressure affecting lungs). This
year there have been many cases of COPD (chronic obstructive pulmonary disease) including
emphysema (disease blocking airflow, difficult to breath) and chronic bronchitis (inflammation of
bronchial tubes). The radiologist lab has performed chest x–rays for the emphysema patients to help
confirm any advanced stages and to rule out other causes of shortness of breath. Chest x–rays
identified cystic fibrosis (inherited disorder clogs lungs with mucous) patients with having
emphysema. In many cases this year a patient had advanced stages of emphysema and required a
lung

Essay about spirometry report
Spirometry Lab Report: Name__________ Lab Section: 1 2 3 Lab Partner(s) _________________
Use your PowerPoint notes, lab book, text book, your data, and the Internet to answer the following
questions. All reports must be typed and stapled. All reports must be in your own words. One
student from each group should include the LabTutor–generated data tables and/or graphs.
Exercise 1: Pulmonary function tests
Respiratory parameter Units Experimental Value Predicted Value*
BPM 14
TV L 0.490L
IRV L 1.984L
ERV L 0.905L
RV L 1.45L
* Go to: http://www.dynamicmt.com/dataform3.html to calculate your predicted values.
1. ... Show more content on Helpwriting.net ...
Which value do you choose and why? (3 pt).
– I choose value the TV "Tidal volume", because I would like to know the amount of air inhaled and
exhaled with breath under resting conditions of the patients.
Exercises 2 & 3: Pulmonary Function Tests: Compare the respiratory parameters between normal
and simulated obstruction. Recall, we simulated an obstructive pulmonary disorder by covering the
tube with duct tape and cutting an opening in it about the size of a pen's diameter. Using the
Horizontal Compression controls and the scroll bar, display the data for both normal pulmonary
function tests (Exercise 2) and the simulated restricted airway (Exercise 3) for inclusion in your
report.
Normal:
Respiratory parameter Experimental Predicted
FVC 3.392L
PIF 214.55L/min
PEF 237.09L/min
FEV1 2.438L
FEV1/FVC 71.88%
Simulated Airway Restiction:

Respiratory parameter Experimental Predicted
FVC 2.101L
PIF 24.04L/min
PEF 26.24L/min
FEV1 0.188L
FEV1/FVC 8.95%
Study Questions
5. There are two major categories that lung diseases fall into: Obstructive and Restrictive. Construct
a small table for each lung condition (obstructive or restrictive) and predict what spirometry
parameters that we measured in lab would most likely be decreased, which parameters would most
likely be unchanged, and which parameters (if any) might be increased. (3 pt). Obstructive
Restrictive
FVC normal or minimally decreased decrease
PIF

Stage 1. Explain:. Begin This Stage By Examining What The
Stage 1
Explain:
Begin this stage by examining what the patient already knows about the topic. Then Explain to the
patient in detail what the he or she needs to know.
Patient and family are aware that the patient has a pneumothorax and that the chest tube was
inserted in order to remove the excess air. The patient knows he needs surgery but does not know
why. The patient and family need to know surgery is needed because they found 3 blebs on his lungs
and that the doctor said there is a 50% chance of a pneumothorax reoccurring if the blebs are not
removed. The patient and family need to know that a pulmonary bleb is a small collection of air
between the lung and the outer surface of the lung. When a bleb ruptures, the air escapes into ...
Asking clarification questions to ensure they understand the material is important in case they do not
understand. This way, if further clarification is needed, the patients and family can get the proper
information they need. Encouraging questions and being open and respectful is important to ensure
all of their questions are answered.
Stage 4
Understanding:
The patient and/or family member should be able to correctly teach back what's been taught.
The teach back method was very effective in assessing the patient's knowledge on the subject.
Having him verbalize the information back to me ensured that he knew the procedure and why it
was done and future signs of a pneumothorax.
V. EVALUATION
Complete the Evaluation on the Worksheet below after conducting your Teach Back session
WORKSHEET
Objectives/Expected Outcome – (This is part of the Planning phase)
Write three measurable objectives for teaching the Identified Teaching Topic. Use Taxonomy verbs
when writing your objectives
1. Patient will list 3 examples of the benefits to getting the bleb removal surgery by the end of the

shift
2. Patient will demonstrate and apply psychomotor skills for proper chest tube care by the end of the
shift
3. Patient will identify and discuss any concerns about the surgery and possible future episodes for
the duration of the shift
Learning Domain – (This is part of the Planning phase)
State the learning

Marfan
–––––––––––––––––––––––––––––––––––––––––––––––––
MARFAN SYNDROME
–––––––––––––––––––––––––––––––––––––––––––––––––
BY MELISSA STEVENS
May 22, 2014 southeastern college
Abstract
Marfan syndrome is a genetic disorder that affects the body's connective tissue. Connective tissue
holds all the body's cells, organs and tissue together. It also plays an important role in helping the
body grow and develop properly. About 1 in 5,000 people have Marfan syndrome, including men
and women of all races and ethnic groups. There is no cure for Marfan syndrome. To develop one,
scientists may have to identify and change the specific gene responsible for the disorder before birth
and medical research has not yet evolved to the point of cure. People ... Show more content on
Helpwriting.net ...
People with Marfan syndrome are born with it, but features of the disorder are not always present
right away. Some people have a lot of Marfan features at birth or as young children – including
serious conditions like aortic enlargement. Others have fewer features when they are young and
don't develop aortic enlargement or other signs of Marfan syndrome until they are adults. Some
features of Marfan syndrome, like those affecting the heart and blood vessels, bones or joints, can
get worse over time. This makes it very important for people with Marfan syndrome and related
disorders to receive accurate, early diagnosis and treatment. Without it, they can be at risk for
potentially life–threatening complications. The earlier some treatments are started, the better the
outcomes are likely to be.
There is no cure for Marfan syndrome. To develop one, scientists may have to identify and change
the specific gene responsible for the disorder before birth. However, a range of treatment options
can minimize and sometimes prevent complications. The appropriate specialists will develop an
individualized treatment program; the approach the doctor's use depends on which systems have
been affected. Annual evaluations are important to detect any changes in the spine or sternum. This
is particularly important in times of rapid growth, such as adolescence. A serious malformation not
only can be

Marfan Syndrome Research Paper
Marfan syndrome is a very common inherited disorder of connective tissue. It is an autosomal
dominant condition occurring one in every 10,000 to 20,000 people . There is a wide variaty in
clinical symptoms in Marfan syndrome with the most occur in eye, Bones, connective tissue and
cardiovascular systems.
Marfan syndrome is caused by transformations in the FBN1 gene. FBN1 mutations are associated
with a broad continuum of physical appearance ranging from isolated features of Marfan syndrome
to a dangerous and rapidly progressive form in infants.
The most common symptom of Marfan syndrome is myopia (nearsightedness from the increased
curve of the retina due to connective tissue changes in the globe of the eye). About 60 percent of
individuals

Essay on How Boyle's Law Relates to Respiratory Care
This paper is going to discuss Boyle's Law and how it relates to respiratory care. It will define what
the law is, how it works, and why it is important to us. We use this law every day without even
thinking about it. So many of our everyday activities and actions are related to certain gas laws that
have been built into our lives at home and at work. Without many of the gas laws we would not have
the advancements that we have today. Boyle's Law has had a very important role in our lives. It is
the reason why we have the medical technology that we have today and why it keeps improving.
Because of Boyle's law, the medical profession saves lives and improves lives every day.
In the 1600's Robert Boyle from Ireland explained the ... Show more content on Helpwriting.net ...
Our bodies do it on their own by moving air into the lungs when a muscle called the diaphragm,
along with other nearby muscles, contract and causes the chest cavity to expand. Then air is exhaled
when these muscles relax, and the lung tissue returns or recoils to its original size (Jardins 2013) .
When the patient needs help with breathing due to a disease, surgery or the use of medications
which stop the muscle from working on their own, a ventilator is a life–saving replacement. The
volume of oxygen in the cylinder is depressed down and the pressure increases moving the oxygen
through the tubes into the patient.
The plethysmography technique applies to Boyle's law and uses measurements of volume and
pressure changes to determine lung volume, assuming the temperature is constant. The
plethysmography technique measures the volume of all compressible gas in the thorax, including
gas trapped behind airway obstructions or in the pleural space (Kacmarek 2013). This is just another
example of how important Boyle's law has become to the medical profession.
As this report states, Boyle's law is very important in our everyday lives and in the medical
profession. The advancements in respiratory care in modern day medicine have been greatly
enhanced with the application of Boyle's law which was developed over 400 years ago by Robert
Boyle a native of Ireland. As a respiratory therapist we work with Boyle's law every day to help
patients

Symptoms And Treatment Of A Healthy 44 Year Old
Abstract:
Pneumomediastinum is a pathologic condition characterized by the presence of air within the
mediastinum and within deep neck spaces. It can be further categorized as spontaneous
pneumomediastinum or secondary pneumomediastinum. Spontaneous pneumomediastinum is a rare
clinical entity seen without any precipitating factors. On the other hand, secondary
pneumomediastinum is due to disruption of the aeordigestive tract, typically from previous surgery,
trauma, severe retching, or foreign body ingestion. Pneumomediastinum can be exacerbated by
activities that generate a valsalva maneuver, as in physical exertion. The treatment protocol differs
substantially between these two entities, so it is crucial that physicians differentiate between the two
by gathering the appropriate history and physical exam. We report a case of a healthy 44 year old
male who developed pneumomediastinum with moderate head and neck subcutaneous emphysema
after minimal trauma while boogie boarding. The patient remained asymptomatic except for mild
dysphonia and head and neck swelling. An extensive PubMed search revealed several case reports
of spontaneous pneumomediastinum. This is, however, to our knowledge, one of the few reports of
moderate to severe spontaneous pneumomediastinum presenting relatively asymptomatically. With
this case report we hope to add to the current body of literature and present an unusual presentation
of spontaneous pneumomediastinum in a healthy individual.
Key Words:

Types And Types Of Pneumothorax
Pneumothorax occurs when air gets into the pleural space between the two layers, and separates
them. Majority of the time only part of the lung collapses, except for in severe cases the whole lung
can collapse, therefore it is emptied of air. The types of pneumothorax being discussed are primary
spontaneous pneumothorax, secondary traumatic pneumothorax, iatrogenic pneumothorax, and open
or tension pneumothorax. Along with the discussion of the pathophysiology, the topics such as
diagnostic tests and primary diagnosis, pharmacological interventions, vulnerable groups, and the
nursing diagnosis are also examined.
Pathophysiology
Primary spontaneous pneumothorax, occurs unexpectedly in healthy people, and it is often caused
by the rupture of blebs which are blister–like formations, on the visceral pleura. Around ten percent
of people affected with this have a family history of primary pneumothorax that was linked to
mutations in the folliculin gene which influences cell–cell adhesion, (Huether & McCance, 1254).
Bleb rupture can occur during rest, sleep, or even exercise. Secondary traumatic pneumothorax can
be caused by chest trauma such as a gun shot wound, stab wound, surgery, or rib fracture. Iatrogenic
pneumothorax is usually caused by transthoracic needle aspiration. Symptoms of iatrogenic
pneumothorax are similar to those of a spontaneous pneumothorax and depend on the age of the
patient, the presence of underlying lung disease, and the extent of the pneumothorax,

Marfan Syndrome Essay
According to my research, client in the case scenario is potential to evolve into the Marfan
syndrome (MFS). According to the Marfan Foundation the diagnosis of Marfan syndrome based on
a set of defined clinical criteria which are known as the Ghent nosology and systemic score. These
criteria help to facilitate accurate recognition of the syndrome. The 2010 Revised Ghent Nosology
for Marfan syndrome relies on seven rules which are based on the Marfan syndrome based on the
two criteria: Four from the absence of family history and three from the presence of family history
(Radke & Baumgartner, 2014). There are also differential diagnoses available for patients aged 20 or
over to recognise Marfan syndrome (Radke & Baumgartner, 2014).
Every person's experience with Marfan syndrome is differently. Person with this disorder has every
feature or different combinations of features. Some features of Marfan syndrome are easily visible.
These include long limb size, tall and thin body type, curved spine chest sinks in or sticks out,
flexible joints, Flat feet, Crowded teeth, Stretch marks on the skin that are not related to weight gain
or loss. In addition to that some most common but not visible are heart problems, especially those
related to ... Show more content on Helpwriting.net ...
Marfan syndrome is a complex disease characterized by abnormally long, thin extremities and
associated with eye and cardiovascular anomalies. In our case study it clearly states that client has
longer than normal arm span and displayed a higher than normal 'lower body to upper body' ratio.
Physical examination also indicates that the limbs are characterized of being long and long thin
fingers. Both pictures of client in the case scenario shows musculoskeletal abnormalities associated
with Marfan disorder. She also has high, arched palate, and pronated feet which are one of the
abnormalities associated with Marfan syndrome (Kaissi, Zwettler, Ganger, Schreiner, Klaushofer,&
Grill,

Symptoms And Treatment Of Child Bearing Age

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