EL 266 - Gas Exchange 1 ISB (WEEK 5)
Questions in this set (87)
Under normal healthy circumstances, the False
atmospheric pressure in the pleural space is
positive. Feedback
The pressure in the pleural space is negative; this is why inspiration requires more
True effort than expiration. This is also why a lung collapses when the integrity of the
False pleural space is broken and the pressure becomes positive.
Secondary lung injury Secondary lung injury --> Closed pneumothorax
Presence of blood in the pleural Presence of blood in the pleural cavity --> Hemothorax
cavity Sudden shift of mediastinal Sudden shift of mediastinal contents to the unaffected side of the chest -->
contents to the unaffected side of the Tension pneumothorax
chest
Hemothorax
Tension pneumothorax
Closed pneumothorax
"Sucking chest wound" "Sucking chest wound" --> open pneumothorax
Prolonged kinking of the chest tube Prolonged kinking of the chest tube --> tension pneumothorax
Rupture of blebs in the lung Rupture of blebs in the lung --> spontaneous pneumothorax
Open pneumothorax
Spntaneous pneumothorax
Tension pneumothorax
,A patient has a pneumothorax. Indicate Second intercostal space
the location(s) where you would expect to Third intercostal space
find a chest tube inserted to resolve the Apical (second or third intercostal space) and anterior chest tube placement
pneumothorax. promotes removal of air, which is necessary in the case of a pneumothorax.
First intercostal space
Second intercostal
space Fifth intercostal
space Fourth
intercostal space Third
intercostal space Sixth
intercostal space
Seventh intercostal
space Eighth intercostal
space Ninth intercostal
space Tenth intercostal
space Eleventh
intercostal space
Indicate the usual locations for insertion of Fifth intercostal
a chest tube to resolve a hemothorax. space Sixth
intercostal space
First intercostal space
Second intercostal space Chest tubes are placed low (usually in the fifth or sixth intercostal space) and
Fifth intercostal space posterior or lateral to drain fluid. Tubes placed in these positions drain blood and
Fourth intercostal space fluid, as in the case of a hemothorax. The seventh or eighth intercostal spaces are
Third intercostal space also a possibility for resolving a hemothorax.
Sixth intercostal space
A patient is being prepared for open-heart In the mediastinum, just below the sternum.
surgery. Where would you expect the chest
tube to be located when the patient returns RATIONALE:
from surgery? A mediastinal chest tube is placed in the mediastinum, just below the sternum.
Mediastinal chest tubes are inserted for open-heart surgery patients to drain
In the second or third intercostal space. fluid away from the pericardial sac. Placing a chest tube in the second or third
In the mediastinum, just below the sternum. intercostal space is for the resolution of a pneumothorax. A chest tube located
In the fifth or sixth intercostal space. in the fifth or sixth intercostal space either posteriorly or laterally is the typical
Posteriorly or laterally. placement to remove blood or fluid from a hemothorax.
A student nurse is working as a tutor for "Physiologically, inspiration is a passive process that requires less work than
a group of freshman physiology expiration."
students. Which statement, if made by
someone in the study group, would RATIONALE:
require correction? The act of inspiration involves more muscles and effort than expiration. Expiration is
a passive activity, whereas inspiration requires the muscles to push against negative
"Normally, atmospheric pressure in the pressure in the pleural cavity. Atmospheric pressure in the pleural space is normally
pleural space is negative." negative (−4 to −10 mm Hg). Besides breathing difficulty, another indication of a
"Besides difficulty breathing, an tension pneumothorax is a shift of the contents in the mediastinum (e.g., trachea
indication of a tension pneumothorax is a and heart) to the opposite (unaffected) side of the chest. Tension pneumothorax can
shift of the contents in the mediastinum also be caused by mechanical ventilation, cardiopulmonary resuscitation (CPR), and
(e.g., trachea and heart) to the opposite prolonged occlusion of chest tubes, such as obstruction of the chest tube by a
(unaffected) side of the chest." blood clot. Patients with chest trauma, fractured ribs, or invasive thoracic bedside
"Obstruction such as caused by kinking or procedures (such as insertion of central lines) and those on high-pressure
clamping of the chest tube can result in a mechanical ventilation are at risk for tension pneumothorax.
tension pneumothorax."
"Physiologically, inspiration is a passive
process that requires less work than
expiration."
, Two nursing students are studying for "When the intactness of the pleural space is broken, the space fills with air and/or
an upcoming exam. One student quizzes fluid, causing positive thoracic pressure, which collapses lung tissue."
the other regarding the cause of a
patient's lung collapsing. What is the RATIONALE:
student's best response? Normally, atmospheric pressure in the pleural space is negative (−4 to −10 mm Hg). If
the integrity of the pleural space is interrupted, the space fills with air and/or fluid,
"When the intactness of the pleural space is causing positive thoracic pressure, which collapses lung tissue.
broken, the space fills with air and/or fluid,
causing positive thoracic pressure, which
collapses lung tissue."
"The exact cause remains unknown, but it is
thought a collapsed lung may occur as a
result of a weakened diaphragm."
"Several factors can cause a lung to
collapse, such as an increase in fibrous
lung tissue, especially in the patient who
smokes."
"The negative pressure between the
parietal pleura and the visceral pleura
becomes too great."
A patient suddenly becomes short of The patient has a tension pneumothorax.
breath, is complaining of chest pain,
and has a drop in blood pressure. The RATIONALE:
nurse auscultates the lung sounds and These symptoms are consistent with a tension pneumothorax as evidenced by the
hears normal lung sounds on the left shift in mediastinal contents.
and very diminished lung sounds on the
right. The patient's trachea appears to be
deviated to the left. What should the
nurse suspect?
The patient has an open pneumothorax.
The patient has a hemothorax.
The patient has a pneumohemothorax.
The patient has a tension pneumothorax.
Your patient complains that the noise of Decrease the wall suction rate to a bubbling volume that the patient can tolerate.
his three-chamber chest tube drainage
system is keeping him awake when he RATIONALE:
tries to sleep. What can you do? Your patient's comfort is always important. Wall suction is required for the unit to
work, but water within the chamber determines whether the unit will work; reducing
Leave the wall suction unit at that rate and the rate of the wall suction to a bubbling rate that the patient can tolerate is the
administer sleeping medication so the best choice.
patient can sleep.
Tell the patient that in order for the
chest tube system to work, the wall
suction unit has to be operating at that
rate.
Decrease the wall suction rate to a
bubbling volume that the patient can
tolerate.
Questions in this set (87)
Under normal healthy circumstances, the False
atmospheric pressure in the pleural space is
positive. Feedback
The pressure in the pleural space is negative; this is why inspiration requires more
True effort than expiration. This is also why a lung collapses when the integrity of the
False pleural space is broken and the pressure becomes positive.
Secondary lung injury Secondary lung injury --> Closed pneumothorax
Presence of blood in the pleural Presence of blood in the pleural cavity --> Hemothorax
cavity Sudden shift of mediastinal Sudden shift of mediastinal contents to the unaffected side of the chest -->
contents to the unaffected side of the Tension pneumothorax
chest
Hemothorax
Tension pneumothorax
Closed pneumothorax
"Sucking chest wound" "Sucking chest wound" --> open pneumothorax
Prolonged kinking of the chest tube Prolonged kinking of the chest tube --> tension pneumothorax
Rupture of blebs in the lung Rupture of blebs in the lung --> spontaneous pneumothorax
Open pneumothorax
Spntaneous pneumothorax
Tension pneumothorax
,A patient has a pneumothorax. Indicate Second intercostal space
the location(s) where you would expect to Third intercostal space
find a chest tube inserted to resolve the Apical (second or third intercostal space) and anterior chest tube placement
pneumothorax. promotes removal of air, which is necessary in the case of a pneumothorax.
First intercostal space
Second intercostal
space Fifth intercostal
space Fourth
intercostal space Third
intercostal space Sixth
intercostal space
Seventh intercostal
space Eighth intercostal
space Ninth intercostal
space Tenth intercostal
space Eleventh
intercostal space
Indicate the usual locations for insertion of Fifth intercostal
a chest tube to resolve a hemothorax. space Sixth
intercostal space
First intercostal space
Second intercostal space Chest tubes are placed low (usually in the fifth or sixth intercostal space) and
Fifth intercostal space posterior or lateral to drain fluid. Tubes placed in these positions drain blood and
Fourth intercostal space fluid, as in the case of a hemothorax. The seventh or eighth intercostal spaces are
Third intercostal space also a possibility for resolving a hemothorax.
Sixth intercostal space
A patient is being prepared for open-heart In the mediastinum, just below the sternum.
surgery. Where would you expect the chest
tube to be located when the patient returns RATIONALE:
from surgery? A mediastinal chest tube is placed in the mediastinum, just below the sternum.
Mediastinal chest tubes are inserted for open-heart surgery patients to drain
In the second or third intercostal space. fluid away from the pericardial sac. Placing a chest tube in the second or third
In the mediastinum, just below the sternum. intercostal space is for the resolution of a pneumothorax. A chest tube located
In the fifth or sixth intercostal space. in the fifth or sixth intercostal space either posteriorly or laterally is the typical
Posteriorly or laterally. placement to remove blood or fluid from a hemothorax.
A student nurse is working as a tutor for "Physiologically, inspiration is a passive process that requires less work than
a group of freshman physiology expiration."
students. Which statement, if made by
someone in the study group, would RATIONALE:
require correction? The act of inspiration involves more muscles and effort than expiration. Expiration is
a passive activity, whereas inspiration requires the muscles to push against negative
"Normally, atmospheric pressure in the pressure in the pleural cavity. Atmospheric pressure in the pleural space is normally
pleural space is negative." negative (−4 to −10 mm Hg). Besides breathing difficulty, another indication of a
"Besides difficulty breathing, an tension pneumothorax is a shift of the contents in the mediastinum (e.g., trachea
indication of a tension pneumothorax is a and heart) to the opposite (unaffected) side of the chest. Tension pneumothorax can
shift of the contents in the mediastinum also be caused by mechanical ventilation, cardiopulmonary resuscitation (CPR), and
(e.g., trachea and heart) to the opposite prolonged occlusion of chest tubes, such as obstruction of the chest tube by a
(unaffected) side of the chest." blood clot. Patients with chest trauma, fractured ribs, or invasive thoracic bedside
"Obstruction such as caused by kinking or procedures (such as insertion of central lines) and those on high-pressure
clamping of the chest tube can result in a mechanical ventilation are at risk for tension pneumothorax.
tension pneumothorax."
"Physiologically, inspiration is a passive
process that requires less work than
expiration."
, Two nursing students are studying for "When the intactness of the pleural space is broken, the space fills with air and/or
an upcoming exam. One student quizzes fluid, causing positive thoracic pressure, which collapses lung tissue."
the other regarding the cause of a
patient's lung collapsing. What is the RATIONALE:
student's best response? Normally, atmospheric pressure in the pleural space is negative (−4 to −10 mm Hg). If
the integrity of the pleural space is interrupted, the space fills with air and/or fluid,
"When the intactness of the pleural space is causing positive thoracic pressure, which collapses lung tissue.
broken, the space fills with air and/or fluid,
causing positive thoracic pressure, which
collapses lung tissue."
"The exact cause remains unknown, but it is
thought a collapsed lung may occur as a
result of a weakened diaphragm."
"Several factors can cause a lung to
collapse, such as an increase in fibrous
lung tissue, especially in the patient who
smokes."
"The negative pressure between the
parietal pleura and the visceral pleura
becomes too great."
A patient suddenly becomes short of The patient has a tension pneumothorax.
breath, is complaining of chest pain,
and has a drop in blood pressure. The RATIONALE:
nurse auscultates the lung sounds and These symptoms are consistent with a tension pneumothorax as evidenced by the
hears normal lung sounds on the left shift in mediastinal contents.
and very diminished lung sounds on the
right. The patient's trachea appears to be
deviated to the left. What should the
nurse suspect?
The patient has an open pneumothorax.
The patient has a hemothorax.
The patient has a pneumohemothorax.
The patient has a tension pneumothorax.
Your patient complains that the noise of Decrease the wall suction rate to a bubbling volume that the patient can tolerate.
his three-chamber chest tube drainage
system is keeping him awake when he RATIONALE:
tries to sleep. What can you do? Your patient's comfort is always important. Wall suction is required for the unit to
work, but water within the chamber determines whether the unit will work; reducing
Leave the wall suction unit at that rate and the rate of the wall suction to a bubbling rate that the patient can tolerate is the
administer sleeping medication so the best choice.
patient can sleep.
Tell the patient that in order for the
chest tube system to work, the wall
suction unit has to be operating at that
rate.
Decrease the wall suction rate to a
bubbling volume that the patient can
tolerate.
