Justin Cavanaugh is a 24-year-old male who is brought to the ED by ambulance following a motor vehicle collision in which he was the restrained driver. On the scene, he was complaining of chest pain that was worse when he took a deep breath in or coughed. His vital signs upon arrival to the ED are HR 102, BP 142/88, RR 32, and SpO2 97% on room air. He is currently complaining of pain to his chest (8/10) and his forehead (5/10) where he has a laceration. A chest X-ray confirmed a right pneumothorax and the plan is to insert a chest tube.
1. How do the patient's vital signs reflect his current situation? Do ny of them concern you and if so, why?
2. What should be the focus of your assessment of this patient? What specific abnormal findings might you notice?
3. What is the priority nursing diagnosis for this patient?
4. The patient is ordered Percocet (Oxycodone 5mg/Acetaminophen 325 mg) 2 tablets for pain <8/10 and morphine 4 mg IVP for pain >8/10. Which would you administer?
5. What would be important to monitor after giving this medication based on this patient's diagnosis?
6. How do you know that the pain medicine was effective?

pneumothorax is a condition that is characterised by air in the space between the lungs and the chest wall.

It can be caused by trauma or injury to the chest or certain medical or surgical procedures to the chest.

Explanation:

Answer 1; There is an increase in heart rate(tachycardia), increased/rapid breathing (tachypnea) and elevated blood pressure which is unlikely in pneumothorax that is characterised by decrease/low blood pressure.

Answer 2; Assessment should focus on tachycardia (increased/rapid breathing), assessment for breath sound and chest wall movement.

Answer 3; Nursing diagnosis will include Respiratory distress and impaired tissue perfusion as a result of air in the lungs.

Answer 4; Acetaminophen because morphine depresses the respiratory centre leading to slower and shallower respiration which won't be favourable for Justin.

Answer 5; SPO2 should be monitored to ascertain decrease in gaseous exchange and respiratory rate to monitor for breathing pattern.

Answer 6; when Justin verbalizes less pain,exhibit calmness and is able to contribute actively/ passively to care rendered.

the real answer is b. scintillation counter

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