Answer Happy

3. Mr. Jones is a 19-year-old male who was in a motor vehicle collision yesterday. He sustained a fractured left radius and fractures to the ribs 4-7 on the left side. He was admitted to the trauma med-surgical ward last night. This morning, he suddenly developed shortness of breath and ‘chest tightness'. He says, “I feel like I can't get a deep breath” and appears very anxious. You assess Mr. Jones to find his SpO2 is 90%, his RR is 32 breath/min, HR is 108 beats/min, and BP is 117/72 mmHg. You auscultate his lungs but find that lung sounds are diminished and almost absent over the left upper lobe. You notified the doctor and chest x-ray STAT was ordered. The chest X-ray confirms moderate sized pneumothorax on the left side, with no shifting of the mediastinum or trachea. The doctor determines the patient needs a chest tube in place. You gather supplies, set up the drainage system and assist with placement of the chest tube on the left side. a. Briefly explain what you expect during the initial placement of chest tube to Mr. Jones. (1 mark) You secure the chest tube with an occlusive dressing and place the drainage system at the foot of the bed. The doctor orders the chest tube to be placed to water seal,

without suction. b. Describe SIX assessments that you would perform to monitor the effectiveness of the chest tube? (3 marks). c. Describe FIVE nursing interventions with rationales for Mr. Jones suffering from acute pain after chest drain insertion. (5 marks) After chest tube insertion, Mr Jones's RR, HR and SpO2 returned normal. Next day, Mr. Jones has sudden onset of chills. You assess Mr. Jones to find his body temperature is 39.5°C, RR is 32 breaths/min, HR is 120 beats/min. SpO2 decreases to 90%. He complains dyspnoea, productive cough, and sore throat. d. List TWO potential complications are suspected based on Mr. Jones' condition? (1 mark) e. Describe FIVE nursing interventions with rationales for Mr. Jones "ineffective breathing" problem. (5 marks)