hemothorax (traumatic)

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I also posted this on the Students thread coz I am just really sooooo lost and am freaking out right now.:banghead:

Hello everyone,

I am writing a care plan on hemothorax. My textbooks doesn't have much information on it. I've searching the web for information that can help me but not much help either. Can somebody please help me?

Why would the pt be on strict bed rest?

What would affect the pulse rate except meds, pain and anxiety?

Why and in what ways can incentive spirometer help a pt with hemothorax? NOTE: I have little info on this and my prof. is very adamant about having a LOT of info on each section of our careplan.:uhoh3:

How would it affect the temperature? Below is what I have about the temperature so far. Is there anything else that you could add?

Temperature - As mentioned above, anxiety and pain due to trauma can cause G.D. to shiver which is a sign of chilling so the nurse should check if G.D. is shivering in order to provide necessary care if needed (Lewis et al, p. 491). G.D. is also at risk for infection due to his wounds and chest tube inserted in his right chest. It's very important for the nurse and other healthcare providers to recognize an infection on an early stage to prevent a more serious complication that it might cause my patient such as septic shock. One way for the nurse to detect an onset of infection is through an elevation of my patient's temperature. Fever is one way the body reacts to an infection. If hyperthermia occurs, a cooling blanket can be provided to help decrease my patient's temperature. But the wound and chest tube insertion site as well as IV sites should also be inspected for redness, inflammation and yellow drainage or pus. The wound should be properly cleaned and an antibiotics should be administered to help fight off the infection. If G.D. develops sepsis, hypo or hyperthermia can occur as well as increased pulse and respiratory rate, decreased BP and decreased urine output (Potter&Perry, p. 500).

In addition to checking G.D.'s core temperature, the nurse should also check my patient's extremities especially her feet. G.D. is on strict bed rest so he would be able to stand up and walk for a couple of days. If G.D. has a decrease in blood supply in his extremities, his hands and feet will feel cold. This might indicate a formation of clot in his legs due to immobility. To help prevent the formation of a clot or a decrease in blood supply to his extremities, an SCD can be use to help push his blood back up to his heart. Also, the nurse can help my patient to do ROM exercises to help with his blood flow especially when G.D.'s leg veins will not be able to pump blood back up to the heart because of lack of activity.

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Specializes in ED, ICU, Education.

Try to look at the big picture. Think about the organ in question and how its physiology relates to your questions.

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Tabers?

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Specializes in Critical Care.

Why would the pt be on strict bed rest?

I can think of two reasons for the bedrest. First, it can be a little difficult for a patient with a chest tube to walk around. You have an increased risk of pulling it out; although, stable patients do walk with chest tubes. Just remember the risk of pulling the tube out (and know what supplies should be by the patient at all times in case of dislodging the tube), and the risk for falling because of the tube.

As for the second reason for bedrest, someone else above me already said it. Think about the organ you're dealing with, the lungs. If you're lung isn't working correctly, what issues might you see?

What would affect the pulse rate except meds, pain and anxiety?

What things normally affect HR? This is true for any patient, so don't make it complicated. It may not be specific to the chest tube or Hemothorax, although it may be a contributing factor. You already listed meds, pain, and anxiety. I can think of 3 more things that may cause an increased HR in your patient. I'll give you one of them, the patient's temp. You mentioned fever in your post. Now there are two more, and they do relate to your chest tube/hemothorax. Think about what would happen if you're patient had the hemothorax and they never placed a chest tube.

Why and in what ways can incentive spirometer help a pt with hemothorax? NOTE: I have little info on this and my prof. is very adamant about having a LOT of info on each section of our careplan.:uhoh3:

The IS will help the patient with a hemothorax in the same way as it helps any other patient. What is the purpose of the IS? What does it do in patients after surgery, or with pneumonia? And as annoying as the IS is, it is a great piece of equipment! I've seen it really help in just a few hours of use.

How would it affect the temperature? Below is what I have about the temperature so far. Is there anything else that you could add?

You seem to have the idea about the temp and its relation to infection. Good luck with your care plan. And thanks for coming to us with a little bit of your own suggestions.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
i also posted this on the students thread coz i am just really sooooo lost and am freaking out right now.:banghead:

hello everyone,

i am writing a care plan on hemothorax. my textbooks doesn't have much information on it. i've searching the web for information that can help me but not much help either. can somebody please help me?

temperature – as mentioned above, anxiety and pain due to trauma can cause g.d. to shiver which is a sign of chilling so the nurse should check if g.d. is shivering in order to provide necessary care if needed (lewis et al, p. 491). g.d. is also at risk for infection due to his wounds and chest tube inserted in his right chest. it’s very important for the nurse and other healthcare providers to recognize an infection on an early stage to prevent a more serious complication that it might cause my patient such as septic shock. one way for the nurse to detect an onset of infection is through an elevation of my patient’s temperature. fever is one way the body reacts to an infection. if hyperthermia occurs, a cooling blanket can be provided to help decrease my patient’s temperature. but the wound and chest tube insertion site as well as iv sites should also be inspected for redness, inflammation and yellow drainage or pus. the wound should be properly cleaned and an antibiotics should be administered to help fight off the infection. if g.d. develops sepsis, hypo or hyperthermia can occur as well as increased pulse and respiratory rate, decreased bp and decreased urine output (potter&perry, p. 500).

in addition to checking g.d.’s core temperature, the nurse should also check my patient’s extremities especially her feet. g.d. is on strict bed rest so he would be able to stand up and walk for a couple of days.

if g.d. has a decrease in blood supply in his extremities, his hands and feet will feel cold. this might indicate a formation of clot in his legs due to immobility. to help prevent the formation of a clot or a decrease in blood supply to his extremities, an scd can be use to help push his blood back up to his heart. also, the nurse can help my patient to do rom exercises to help with his blood flow especially when g.d.’s leg veins will not be able to pump blood back up to the heart because of lack of activity.

http://www.e-radiography.net/radpath/d/dvt.htm

let me google that for you

in any situation don't panic..........take your own pulse first this will give you time to calm down and think.

then consult google http://www.scribd.com/doc/17471582/nursing-care-plan-for-hemothorax-pneumothorax

why would the pt be on strict bed rest? depending the reason for the hemothorax. the most common reason for a hemothorax is trauma to the chest. hemo--blood in the chest can be life threatening. incerasing physical activity before the traumatic bleeding has had a chance to stop can increase bleeding and cause another condition called tension hemothorax. the bedrest would be in direct coorelation to minimize activity to minimize bleeding and chance of further trauma.......and to minimize disloging the chest tube.

http://en.wikipedia.org/wiki/hemothorax https://health.google.com/health/ref/hemothorax

what would affect the pulse rate except meds, pain and anxiety? think fluid volume as in lack there of......hypovolemia and tachycardia. hypothermia,hypovolemia and bradycardia.(very late sign) temperature for infection to name a few http://lmgtfy.com/?q=hemothorax+are+plans

why and in what ways can incentive spirometer help a pt with hemothorax? note: i have little info on this and my prof. is very adamant about having a lot of info on each section of our careplan.:uhoh3: http://www.doctor-clinic.org/injuries/blunt-chest-injuries.html

http://lmgtfy.com/?q=hemothorax+and+incentive+spirometry

how would it affect the temperature? below is what i have about the temperature so far. is there anything else that you could add?

immediate trauma are at risk for hypothermia due to /in and out of hospitaland rapid iv administration

http://lmgtfy.com/?q=temperature+and+trauma%2fhemothorax

[color=#0e774a]www.medlectures.com/.../trauma%20lectures/chest%20trauma%20basics.

i hope this helps........but the internet is a wealth of knowledge:rolleyes:

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let me google that for you

in any situation don't panic..........take your own pulse first this will give you time to calm down and think.

then consult google http://www.scribd.com/doc/17471582/nursing-care-plan-for-hemothorax-pneumothorax

why would the pt be on strict bed rest? depending the reason for the hemothorax. the most common reason for a hemothorax is trauma to the chest. hemo--blood in the chest can be life threatening. incerasing physical activity before the traumatic bleeding has had a chance to stop can increase bleeding and cause another condition called tension hemothorax. the bedrest would be in direct coorelation to minimize activity to minimize bleeding and chance of further trauma.......and to minimize disloging the chest tube.

http://en.wikipedia.org/wiki/hemothorax https://health.google.com/health/ref/hemothorax

what would affect the pulse rate except meds, pain and anxiety? think fluid volume as in lack there of......hypovolemia and tachycardia. hypothermia,hypovolemia and bradycardia.(very late sign) temperature for infection to name a few http://lmgtfy.com/?q=hemothorax+are+plans

why and in what ways can incentive spirometer help a pt with hemothorax? note: i have little info on this and my prof. is very adamant about having a lot of info on each section of our careplan.:uhoh3: http://www.doctor-clinic.org/injuries/blunt-chest-injuries.html

http://lmgtfy.com/?q=hemothorax+and+incentive+spirometry

how would it affect the temperature? below is what i have about the temperature so far. is there anything else that you could add?

immediate trauma are at risk for hypothermia due to /in and out of hospitaland rapid iv administration

http://lmgtfy.com/?q=temperature+and+trauma%2fhemothorax

[color=#0e774a]www.medlectures.com/.../trauma%20lectures/chest%20trauma%20basics.

i hope this helps........but the internet is a wealth of knowledge:rolleyes:

thank you so much. this helps a lot. and you are right...i panic and couldn't think straight which just made the situation worst. you are such a big help. thank you very much.:bow:

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I can think of two reasons for the bedrest. First, it can be a little difficult for a patient with a chest tube to walk around. You have an increased risk of pulling it out; although, stable patients do walk with chest tubes. Just remember the risk of pulling the tube out (and know what supplies should be by the patient at all times in case of dislodging the tube), and the risk for falling because of the tube.

As for the second reason for bedrest, someone else above me already said it. Think about the organ you're dealing with, the lungs. If you're lung isn't working correctly, what issues might you see?

What things normally affect HR? This is true for any patient, so don't make it complicated. It may not be specific to the chest tube or Hemothorax, although it may be a contributing factor. You already listed meds, pain, and anxiety. I can think of 3 more things that may cause an increased HR in your patient. I'll give you one of them, the patient's temp. You mentioned fever in your post. Now there are two more, and they do relate to your chest tube/hemothorax. Think about what would happen if you're patient had the hemothorax and they never placed a chest tube.

The IS will help the patient with a hemothorax in the same way as it helps any other patient. What is the purpose of the IS? What does it do in patients after surgery, or with pneumonia? And as annoying as the IS is, it is a great piece of equipment! I've seen it really help in just a few hours of use.

You seem to have the idea about the temp and its relation to infection. Good luck with your care plan. And thanks for coming to us with a little bit of your own suggestions.

Thank you very much. These are good info and I love that you did not exactly just give me the answers but you were kinda just directing my thinking to the right direction. In this case, you were helping me without doing all the work. So I would still be helping myself in the process coz I would still need to do some thinking here. Thanks a lot. I really appreciate your help.:bow::bow::bow:

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thank you so much. This helps a lot. And you are right...I panic and couldn't think straight which just made the situation worst. You are such a big help. Thank you very much.:bow:

YOUR WELCOME!:redbeathe

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