Pneumothorax NCLEX Review Notes

Introduction

• A pneumothorax involves a collapsed lung due to air leaking into the intrapleural space.
• Important for nursing exams and practice to recognize signs, symptoms, diagnosis, interventions, and educate patients.

Topics Covered

• Definition of pneumothorax
• Pathophysiology
• Types of pneumothorax
• Signs and Symptoms
• Nursing Interventions

Definition

• Collapse of a lung due to air in the pleural space between visceral and parietal pleura.
• Can be partial or total collapse, mainly affecting one lung.
• Causes include spontaneous events, chest trauma, lung disease, or medical procedures.
• Diagnosed through imaging like chest X-ray, ultrasound, or CT scan.

Pathophysiology

• Visceral pleura (attaches to lungs) and parietal pleura (attaches to chest wall) are separated by serous fluid in the intrapleural space.
• Intrapleural space maintains negative pressure, acting like suction to keep lungs inflated.
• Air entry disrupts this pressure balance, leading to lung collapse.

Types of Pneumothorax

Open Pneumothorax

• Occurs with an opening in the chest wall (e.g., gunshot, stabbing) connecting outside air with intrapleural space.
• Nursing intervention: Apply a sterile occlusive dressing, tape on 3 sides.

Closed Pneumothorax

• Air leaks into the intrapleural space with no external chest wound.
• Can be due to rib fracture or spontaneous causes like pulmonary bleb.

Tension Pneumothorax

• Medical emergency; air enters intrapleural space but cannot escape.
• Causes shifts and compression of mediastinum and major vessels.
• Treated with needle decompression.

Signs & Symptoms (Mnemonic: COLLAPSED)

• Chest pain, Cyanosis
• Overt tachycardia and tachypnea
• Low blood pressure, Low oxygen saturation
• Absent lung sounds on affected side
• Pushing of trachea to unaffected side
• Subcutaneous emphysema, Sucking sound
• Expansion of chest unequal
• Dyspnea

Nursing Interventions

• Monitor breath sounds, chest rise, vital signs, and breathing effort.
• Maintain chest tube drainage system, ensure no air leaks.
• Elevate head of the bed (Fowler's position).

Additional Resources

• Nurse Sarah's ABG Interpretation Notes and Workbook available in eBook or physical copy format.