hemothorax, chylothorax, thoracentesis

Question 1

What is a hemothorax?

Answer 1

An accumulation of blood in the pleural space from injury to the chest wall, diaphragm, lung, blood vessels, or mediastinum.

Question 2

What causes hemothorax?

Answer 2

Injury to one of these areas (not necessarily all): chest wall, lungs, mediastinum, or blood vessels.

Question 3

Why does hemothorax cause respiratory distress?

Answer 3

Blood in the pleural space pushes lung tissue up, preventing full expansion.

Question 4

Why is tachycardia seen in hemothorax?

Answer 4

Compensatory response to impaired oxygenation and blood loss.

Question 5

Why is pain common in hemothorax?

Answer 5

Ongoing bleeding and tissue injury.

Question 6

What happens to breath sounds in hemothorax?

Answer 6

Decreased or absent breath sounds on the affected side.

Question 7

How does percussion differ: hemothorax vs pneumothorax?

Answer 7

Hemothorax: dullness (fluid/blood). Pneumothorax: hyperresonance (air).

Question 8

What oxygenation change occurs in hemothorax?

Answer 8

Hypoxia due to reduced lung expansion and gas exchange.

Question 9

What hemodynamic change is typical in hemothorax?

Answer 9

Hypotension from blood loss (not typically seen early in pneumothorax).

Question 10

What key history/physical findings suggest hemothorax?

Answer 10

Trauma history, decreased lung sounds, percussion dullness (vs hyperresonance in PTX).

Question 11

What does chest X-ray show in hemothorax vs pneumothorax?

Answer 11

Hemothorax: area may appear whited out (fluid). Pneumothorax: more black/air (negative space).

Question 12

What other imaging helps diagnose hemothorax?

Answer 12

CT chest; bedside chest ultrasound (rapid trauma assessment for pleural fluid).

Question 13

Primary treatment for hemothorax?

Answer 13

Chest tube insertion to drain blood and re-expand lung.

Question 14

What is autotransfusion in hemothorax?

Answer 14

Recycling the patient’s blood collected via chest tube back into circulation.

Question 15

Key respiratory assessments for hemothorax nursing care?

Answer 15

Assess rate, depth, ease of breathing; watch for signs of distress; auscultate lungs; monitor SpO₂.

Question 16

Preferred positioning for hemothorax patients?

Answer 16

Semi-Fowler’s or High-Fowler’s to ease breathing.

Question 17

Why encourage frequent repositioning in hemothorax?

Answer 17

Reduce pressure ulcer risk, promote lung expansion, and help prevent blood clots.

Question 18

Why encourage deep breathing and early mobility with a chest tube?

Answer 18

Improves ventilation/expansion and prevents muscle atrophy; chest tube is not a reason to avoid movement.

Question 19

What is a chylothorax?

Answer 19

Lymphatic fluid in the pleural space due to lymphatic system damage, usually from trauma or malignancy.

Question 20

What history can point toward chylothorax?

Answer 20

History of lung cancer (malignancy-related lymphatic disruption).

Question 21

Chylothorax clinical manifestations?

Answer 21

Severe cough, chest pain, difficulty breathing.

Question 22

Chylothorax diagnostics (key points)?

Answer 22

H&P (duration of cough/dyspnea), lung sounds, chest X-ray.

Question 23

First-line procedural treatment for chylothorax?

Answer 23

Drainage via thoracentesis (remove pleural fluid into vacuum chambers).

Question 24

Why isn’t thoracentesis used to rapidly remove blood in hemothorax?

Answer 24

Rapid removal of blood can trigger cardiac arrest; prefer controlled drainage via chest tube.

Question 25

What medication can reduce lymph flow in chylothorax?

Answer 25

Octreotide (decreases lymphatic fluid production/flow).

Question 26

What procedure can prevent recurrence in chylothorax?

Answer 26

Pleurodesis (adhere pleural layers to seal space).

Question 27

What is a thoracentesis?

Answer 27

Procedure to remove fluid or air from around the lungs by inserting a needle through the chest wall into the pleural space.

Question 28

Thoracentesis is usually a treatment for what?

Answer 28

Pleural effusion.

Question 29

Risks of thoracentesis?

Answer 29

Pneumothorax, infection, bleeding, rare liver/spleen injury (accidental puncture).

Question 30

How to tell a patient is improving after thoracentesis?

Answer 30

Higher O₂ sats, easier breathing, improved lung sounds.

Question 31

Nursing interventions for thoracentesis?

Answer 31

Maintain positioning, monitor respiratory status, set up for procedure, document amount removed post-procedure.