Presence of air gas or fluid in pleural space causing

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Presence of air, gas, or fluid in pleural space, causing the lungs to collapse  (several types) Air can enter the pleural space from an open chest wound, or internal  rupture or leak of lung alveolar Clinical signs are related to size of lung collapse and range from minor to  life-threatening Classic onset is sudden sharp chest pain; decreased breath sounds and  chest movement on affected side; hypotension, diaphoresis; elevated  temperature; pallor; dizziness; anxiety and hypoxia Open Pneumothorax Cause : puncture wound through the chest wall Air entry:  from outside through hole in thorax or parietal pleura Effects:  atelectasis; air enters pleural space with each inspiration and exits with  each expiration; unaffected lung compressed by mediastinal shift on inspiration  mediastinal flutter decreases venous return to the heart Signs & Symptoms:  increased labored respiration dyspnea, tachycardia, pleural  pain, asymmetrical chest movement, suckling chest wound, tracheal swing,  decreased BP, and moderate hypoxemia Closed Pneumothorax Simple or spontaneous tear on the surface of the lungs Secondary:  associated with respiratory disease Effects:  atelectasis, leak seals as lung collapses; one lung in impaired; there are no  other cardiovascular signs Signs & Symptoms:  increased labored respiration, dyspnea, tachycardia, plural  plain, asymmetrical chest movement, absent breath sounds, and hypoxemia -Can result in tension pneumothorax Tension Pneumothorax (SERIOUS) Air enters through an opening in chest wall and parietal pleura or from a  tear in the lung tissue and visceral pleura. Air cannot leave which causes  air trapping Air accumulates increasingly compressing unaffected lung, leads to 
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mediastinal shift and reduced venous return to the heart Signs & Symptoms:  Increased labored respiration, dyspnea, tachycardia, pleural  pain, asymmetrical chest movement, mediastinal shock, hypoxemia Treatments:  emergency needle decompression or chest tube placement Problem with Adult Respiratory Distress Syndrome: hypoxemia that happens despite the fact they’re getting oxygen (refractory hypoxia) – always a secondary disorder Adult Respiratory Distress Syndrome Results from injury to the alveolar wall and capillary membrane Resulting in the release of chemical mediators Increased fluid and protein in interstial area and alveoli Damage to surfactant- producing cells Diffuse necrosis and fibrosis if patient survives Multitude of predisposing conditions Often associated with multiple organ dysfunction or failure Signs & Symptoms Dyspnea Restlessness Rapid, shallow respirations Increased heart rate Combination of respiratory and metabolic acidosis Treatment:
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