NSG 232 Exam #3 Part 1-Questions with Correct Answers/
Verified/ Latest Update
Nitroprusside - ✔✔generic
Nitroglycerin - ✔✔generic
Labetalol - ✔✔generic
Esmolol - ✔✔generic
Fenoldopam - ✔✔generic
Nicardipine - ✔✔generic
Clevidipine - ✔✔generic
Enalaprilat - ✔✔generic
Hydralazine - ✔✔generic
Pneumothorax - ✔✔Air in the pleural space that prevents lung expansion
What is normally in the pleural space? - ✔✔2.5mL of fluid for lubrication to reduce the
friction when lung tissues move.
What is normal pressure in the pleural space? - ✔✔Negative pressure
Closed pneumothorax - ✔✔No external wound. Air from internal puncture or tear in the
respiratory structure (emphysema blebs rupture; insertion of subclavian catheter; injury
from mechanical ventilator).
,Treatment for closed pneumothorax - ✔✔Depends on cause. Minimal air may resolve on its
own. Minimal air/fluid can be aspirated (thoracentesis). Insertion of chest tube connected
to water-seal drainage.
Open pneumothorax - ✔✔External chest wound.
Aka "sucking" chest wound, when air enters pleural space through chest wall during
inspiration.
Seal open wound, occlusive dressing, sealed on 3 sides.
What does a dressing sealed on 3 sides do? - ✔✔During inspiration, as negative pressure is
created in the chest, the dressing pulls against the wound preventing air from entering
pleural space. During expiration as pressure rises in pleural space, the dressing is pushed out
and air escapes through the wound and from under the dressing.
Tension pneumothorax definition and tx - ✔✔Air moves into the pleural space and cant get
out. Can occur with open or closed pneumo.
Tx: Insert large bore needle into anterior chest wall at 4th or 5th intercostal space to release
trapped air. Chest tube inserted and connected to water-seal drainage. Support oxygen
What does a tension pneumothorax cause? - ✔✔Compression of the lung on the affected
side puts pressure on heart and great vessels pushing them away from affected side,
compressing other lung. Pressure increases and venous return is decreased and CO falls.
Muffled heart sounds occur, neck vein distention.
Causes and s/s of tension pneumothroax - ✔✔Chest tubes may become clamped or
blocked. Tubes need to be unclamped to relieve tension.
S/s: dyspnea, chest pain radiating to shoulder, tracheal deviation, decreased or absent
breath sounds on affected side, neck vein distention, cyanosis.
Spontaneous pneumothorax - ✔✔occurs without known cause.
Fractured Ribs - ✔✔Usually ribs 5-10
Can cause tear in pleura, atelectasis r/t decreased ventilation and retained secretions
Management for fractured ribs - ✔✔Pain control
Limit lifting/activity
Intercostal nerve block
DO NOT restrict chest movement
Flail Chest - ✔✔Paradoxical movement of chest wall during respiration. 3 or more fractured
ribs, anterior/posterior with each rib.
Tx for flail chest - ✔✔Restore adequate ventilation
May need ventilator
Pain management
Anxiety management
Closed chest drainage - ✔✔Removes air and/or fluid from pleural space.
Equalizes pressure in lung.
Re-expands the lung and prevents mediastinal shift
Chambers' function - ✔✔Water seal
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