PNEUMOTHORAX&HEMOTHORAX Definition causes signs and symptoms nursing careplans medical management complications

1. PNEUMOTHORAX
&
HEMOTHORAX MANAGENT
IN E.R.
Gufu ABDIKADIR
BSCN/2015/40718

2. PNEUMOTHORAX
…

3. DEFINITION
 *lung disorder whereby there is collection
of air in the pleural space that causes
partial/whole collapse of the lung

4. Pathophysiology
 May be caused by trauma secondary to medical
procedure e.g. thoracocentesis
 (*thoracentesis is a procedure to pleural fluid from
the pleural space either for RX/Dx purposes.
 Normal physiology; pressure in lungs is greater than
pressure in pleural cavity
 Pathophysiology; trauma = air enters the pleural
space thus pleural space pressure is equal/higher
than lung pressure. ^se in pressure leads to lung
collapse, compresses the heart and pushes it towards
the unaffected side.
 Thus pneumothorax should be managed in the ER AS
FAST AS POSSIBLE.

5. Types of Pneumothorax
Spontaneous PNEUMOTHORAX
 Occurs suddenly with no known reason. Result from
rupture of small air sacs.
 Occurs commonly in men aged 20-40y who are tall and
thin in nature. It also affects people sufferin from TB, cystic
fibrosis of the lungs.
Traumatic PNEUMOTHORAX
 results from medical procedure e.g MV&thoracocentesis.
Tension PNEUMOTHORAX
 Life threatening; caused by traumatic injury. Air enters
chest cavity and cannot escape. This = to extreme ^se in
pressure in pleural cavity than the lungs leading to lung
collapse and compression of the heart.

6. Causes
1. IDIOPATHIC; tall thin men
2. blunt/penetrating chest injury e.g
gunshot
3. certain medical procedures e.g MV
4. damage from underlying lung disease
e.g TB

7. Who is at risk?

8. Signs and symptoms
1. chest pain; sudden, sharp in nature esp.
on deep breathing and coughing
2. shortness of breath; due to decreased
pressure in the lungs

10. ManAgement
AIM;
 Relieve pressure on the lungs to ensure normal
breathing by removing air
 Re-expanding the lungs
 Preventing re-ocurrence
REMEDIES;
i. Observation; with mild/no symptoms simple close
monitoring with a series of chest X-rays until the air
is completely absorbed and the lung has re-
expanded.
 Requires bed rest as any exertion may aggravate
the collapse.
 Supplemental oxygen can speed the absorption
process

11. Dx
 Auscultation; physical
 chest x ray- show the air pocket and the
collapsed lung
 electrocardiogram (ECG) will be performed to
record the electrical impulses that control the
heart's activity
 Blood sample for ABG analysis.

12. Cont…
 Needle Aspiration/Chest tube insertion
larger area of lung has collapsed, chest tube
will be used to remove the air. The hollow
needle or tube is inserted between the ribs into
the air-filled space that is pressing on the
collapsed lung. With the needle, a syringe is
attached so the doctor can pull out the excess
air - just like a syringe is used to pull blood
from a vein. Chest tubes are often attached to
a suction device that continuously removes air
from the chest cavity and may be left in place
for several hours to several day

14. NURSING CAREPLAN
ASSESSMENT;

15. NURSING DX
 Ineffective breathing pattern r/t impaired
lung expansion as evidenced by shortness
of breath
 Impaired gas exchange r/t collapse of the
lung tissue as evidenced by decreased
arterial blood gas analysis
 Acute pain related to increased pressure
in the pleural cavity

16. Nursing Intervention

17. hemothorax
…

18. Definition
 Collection of blood in the pleural cavity
 Special type of pleural effusion in which blood
accumulates in the pleural cavity. This excess
fluid can interfere with normal breathing by
limiting the expansion of the lungs..

19. Causes
• blood not clotting properly and leaking into the chest
cavity
• cancer in the lungs
• fluid and cancer around the lungs, called malignant
pleural effusion
• cancerous tumors in your chest wall
• large vein torn open when a catheter is inserted
while you’re in the hospital
• tissue around your lungs dying, called pulmonary
infarction
• Trauma; blunt/penetrating

20. SIGNS&SYMPTOMS
• pain or feeling of heaviness in your chest
• feeling anxious or nervous
• dyspnea, or having trouble breathing
• breathing quickly short
• abnormally fast heartbeat
• breaking out in cold sweats
• skin turning pale

21. DX
 CT SCAN
 X-RAY

22. Medical mgt
 Chest tube insertion
 Surgery

23. Nursing Careplan
REFER PTX ABOVE