Predisposing/Precipitating Factors

Pathophysiology
Signs/Symptoms
Diagnostic Exams
Medical Treatment
Complication
Nursing Diagnosis
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Pathophysiology
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Surgery (Thoracostomy or MiniThoracotomy)

Empyema
Fibrothorax
Thoracotomy
Decortication

FAST Ultrasound
Upright chest radiograph

Chest Drain
(closed system)
Thoracotomy

Blood that enters ches

exposed to motion of d
lungs and other intra
structures

Defibrination of the blood

results so that incomplete
clotting occurs

Within several hours, lysis of

existing clots by pleural
enzymes begins
Lysis of RBCs results in
protein concentration of the
pleural fluid
Increased permeability

Fluid leaks into the pleural

space

Pleural Effusion

Predisposing Factors
Age
Gender

Occurence of the
incident (kicking)

Decreased chest and

lung expansion

FAST Ultrasound
ight chest radiograph

Dullness on affected
part upon percussion
Reduced breath sounds
in affected part

Chest Drain
(closed system)
Thoracotomy

Ineffective breathing
pattern r/t decreased
lung expansion
secondary to fluid
accumulation

Blood that enters chest cavity is

exposed to motion of diaphragm,
lungs and other intrathoracic
structures

Blunt trauma on left side

lung

Force causes disruption

the tissues of the chest w
and pleura

Bleeding occurs
Jugular Vein
Distension
Blood accumulates in the
cavity

Pressure becomes more

positive

Disruption of normal
respiratory movemen

Defibrination of the blood

results so that incomplete
clotting occurs

Within several hours, lysis of

existing clots by pleural
enzymes begins

Lysis of RBCs results in

rotein concentration of the
pleural fluid
Increased permeability

Fluid leaks into the pleural

space

Pleural Effusion

Abnormalities of
ventilation and
oxygenation may occu

Tachypnea
RR- 40 CPM, Shallow

Dyspnea and pain upo

breathing

Precipitating Factors
Chest Trauma
Occupational Hazards
Environmental Hazards
alcohol consumption

Occurence of the
incident (kicking)

Blunt trauma on left side of

lung

Force causes disruption of

the tissues of the chest wall
and pleura

Bleeding occurs

Blood accumulates in the chest

cavity
Pressure becomes more
positive

Disruption of normal
respiratory movement

- External bruising on the affected part

- Areas of tenderness over affected side

Impaired gas exchange r/t

altered oxygen supply

Excessive bleeding
(hemothorax)

Palpable fremitus

Mediastinal shift (R)

Abnormalities of
ventilation and
oxygenation may occur

Tachypnea
RR- 40 CPM, Shallow
Dyspnea and pain upon
breathing

Chest X-rayImpression:
Hemothorax
CT scan:
Hemothorax and Tension

ising on the affected part

derness over affected side

exchange r/t
n supply

ABG:

Blood Loss of 4000 mL (12

hours) and 1000 mL (retained
clots)
Hypovolemic
shock

DEATH

Early signs:
Abrupt decrease in
blood pressure
Tachycardia
105 BPM
Ineffective tissue perfusion
r/t excessive blood loss

Tachypnea
40 CPM
Decreased pulse
ampitude and rhythm
(Weak and Threading)

Tachypnea
40 CPM
Decreased pulse
ampitude and rhythm
(Weak and Threading)

ression:
ax
Tension

DEATH

y signs:

decrease in
pressure

hycardia
5 BPM

hypnea
0 CPM

ased pulse
e and rhythm
d Threading)

hypnea
0 CPM

ased pulse
e and rhythm
d Threading)