Postoperatively, symptoms that may indicate hemothorax or internal bleeding in a video-assisted thoracic surgery (VATS) patient include
Answer(s): A
Diminished breath sounds are one of the symptoms that may indicate hemothorax or internal bleeding in a video-assisted thoracic surgery (VATS) patient. VATS is a minimally invasive surgical technique that uses a small video camera (thoracoscope) and special instruments to access the chest cavity through small incisions. Hemothorax is a condition where blood accumulates in the pleural space, the area between the lungs and the chest wall. Hemothorax can occur as a complication of VATS due to injury to the lung, blood vessels, or chest wall during the procedure. Hemothorax can cause compression of the lung and reduce its expansion, leading to diminished breath sounds on the affected side. Other symptoms of hemothorax may include chest pain, shortness of breath, low blood pressure, rapid heart rate, and pale or clammy skin. Internal bleeding is another possible complication of VATS that can cause similar symptoms as hemothorax. Internal bleeding can occur due to damage to the major vessels, such as the aorta, pulmonary artery, or vena cava, during VATS. Internal bleeding can cause hypovolemia, which is a decrease in the volume of blood in the body, and hypoxemia, which is a low level of oxygen in the blood. These conditions can impair the delivery of oxygen to the tissues and organs, including the lungs, and cause diminished breath sounds, as well as other signs of shock, such as confusion, weakness, dizziness, and loss of consciousness.Pain with deep inspiration, bradycardia, and hypertension are not typical symptoms of hemothorax or internal bleeding in a VATS patient. Pain with deep inspiration may be a normal postoperative finding after VATS, as the incisions and the chest tube may cause discomfort. Bradycardia and hypertension may be caused by other factors, such as medications, cardiac disorders, or neurological conditions, but they are not directly related to hemothorax or internal bleeding .
1: Video-Assisted Thoracoscopic Surgery (VATS) | Johns Hopkins Medicine2: Hemothorax: Causes, Symptoms, Diagnosis & Treatment - Cleveland Clinic23: Complications of video-assisted thoracoscopic surgery: a retrospective analysis of 3000 cases - PubMed: Major vascular complications after video-assisted thoracoscopic surgery: a case report and literature review - PubMed: Video-Assisted Thoracoscopic Surgery (VATS) | Michigan Medicine : Bradycardia - Symptoms and causes - Mayo Clinic: High blood pressure (hypertension) - Symptoms and causes - Mayo Clinic
A patient who is post repair of an abdominal aortic aneurysm should be monitored for which of the following complications?
Acute renal failure is one of the possible complications of abdominal aortic aneurysm (AAA) repair, especially after open surgery. Acute renal failure is a sudden loss of kidney function that can cause fluid and electrolyte imbalance, acid-base disturbance, and uremic syndrome. Acute renal failure can occur due to several factors, such as hypoperfusion of the kidneys, atheroembolism, contrast- induced nephropathy, or ischemia-reperfusion injury. The incidence of acute renal failure after AAA repair ranges from 2 to 25%, depending on the definition, the type of surgery, and the patient's risk factors. Acute renal failure is associated with increased morbidity, mortality, and length of hospital stay after AAA repair.Other complications of AAA repair include bleeding, infection, wound complications, graft-related complications, bowel ischemia, spinal cord ischemia, and cardiac, pulmonary, or neurological events. Acute hepatic dysfunction, acute CVA, and atrial fibrillation are not specific complications of AAA repair, but they may occur in any major surgery or in patients with preexisting conditions.
A patient with hypertension received tPA for an acute embolic stroke with complete resolution of symptoms. Twenty-four hours after tPA administration, the nurse should anticipate an order for
Answer(s): C
A 22-year-old trauma patient sustained multiple fractures after a fall. The patient fell 50 feet from a cliff while rock climbing without a harness. The patient is intubated and sedated with casts to bilateral lower extremities. The nurse should recognize that young adults are
In septic shock, a mixed venous O2 saturation (SO2) of 84% indicates that
Answer(s): D
A high mixed venous O2 saturation (SO2) indicates that the tissue cells are not extracting enough oxygen from the blood, which can be due to impaired cellular metabolism or increased oxygen delivery. In septic shock, there is often a mismatch between oxygen delivery and consumption, resulting in a high SO2 despite tissue hypoxia. Therefore, SO2 alone is not a reliable indicator of tissue perfusion in septic shock.
Mixed venous oxygen saturation (SvO2) monitoring · LITFL · CCC SvO2 to monitor resuscitation of septic patients: let's just understand the basic physiology | Critical Care | Full TextReference Guide for CCRN (Adult), page 14.
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