Spontaneous Pneumothorax

A.W., a 72-year-old woman with 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, started on intravenous

Iactated Ringer’s at KVO (keep vein open), and transported to the nearest emergency department (ED)……….On

A.W.’s anal at the ED, the physician auscultates muffled heart tones, no breath sounds on the right, and faint

sounds on the left. A.W. is stuporous, tachycardic, and cyanotic. The paramedics inform the physician that it

was difficult to ventilate A.W. A portable chest x-ray (CXR) examination shows an 80% pneumothorax on the

right…..ArteriaI Blood Gases (A863; 100% 02):

pH 7.25,

Paco2 92 mm Hg,

Pao2 32 mm Hg,

HCOS 27 mmol/L,

Spo2 53%…….The ED physician inserts a size 32 Fr chest tube in the sixth intercostal space, midaxillary

Iine………Think through the following related to A.W.’s condition: Question 1) Etiology and pathophysiology. Q2)

Risk factors. Q3) Signs and symptoms. Q4) Diagnostic procedures. Q5) Medication and treatment. Q6) Nursing

interventions, including patient education (Prioritize the nursing interventions related to complications). Q7)

Potential complications………Include at least three peer-reviewed sources to support your concept map, and an

Sample Solution

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