Chest Trauma Paper

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Chest trauma disrupts the structural integrity of the chest wall, and as a consequence may develop flail chest or rib fracture. A flail chest results when three or more ribs are fractured at two or more sites or when the ribs become disarticulated from their cartilage attachments with the sternum. The flail moves outward on exhalation which create an increase in pleural pressure and inward on inhalation. This abnormal movement is called paradoxical chest movement. Bony fragments from a fractured rib may lacerate the lung and cause a pneumothorax or hemothorax. Gas exchange, coughing, and clearance of secretions may all become impaired, therefore vigilant respiratory care must be managed with flail chest and rib fractures. With severe hypoxemia and hypercarbia, intubation and mechanically ventilated with positive end-expiratory pressure, also known as PEEP may be required (Ignatavicius & Workman (2013), p. 683). PEEP improves oxygenation by means of maintain certain amount of pressure (5-15 cm H2O), within the chest cavity, therefore prevents alveoli from collapsing. PEEP enhances gas exchange and prevents atelectasis because the alveoli are kept partially inflated.
The chest wall
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As a nurse the primary role in pain management is advocation for the patient by believing reports of pain and act promptly to relieve it, while respect the patient’s preferences and values (Ignatavicius & Workman (2013), p.39). Expected outcome client report that pain management regimen achieves comfort-function goal without side effects, perform activity of recovery or ADLs easily, as well as notify health care team promptly for pain intervention when pain is consistently greater than the comfort-function

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