3 Hemothorax and Pneumothorax Nursing Care Plans

February 27, 2014

A collapsed lung happens when air (pneumothorax), blood (hemothorax), or other fluids (pleural effusion) enters the pleural space, the area between the lung and the chest wall. The intrathoracic pressure changes induced by increased pleural space volumes reduce lung capacity, causing respiratory distress and gas exchange problems and producing tension on mediastinal structures that can impede cardiac and systemic circulation. Pneumothorax may be traumatic (open or closed) or spontaneous.

Nursing Care Plans

Nursing care planning and management for patients with hemothorax or pneumothorax includes management of chest tube drainage, monitoring respiratory status, and providing supportive care.

Below are three (3) nursing care plans (NCP) and nursing diagnosis (NDx) for patients with pneumothorax and hemothorax:

Deficient Knowledge

Deficient Knowledge: Absence or deficiency of cognitive information related to specific topic.

May be related to

Lack of exposure to information

Possibly evidenced by

Expressions of concern, request for information
Recurrence of problem

Desired Outcomes

Verbalize understanding of the cause of the problem.
Identify signs/symptoms requiring medical follow-up.
Follow the therapeutic regimen and demonstrate lifestyle changes if necessary to prevent recurrence.

Nursing Interventions	Rationale
Ascertain pathology of the individual problem.	Information reduces the fear of unknown. Provides knowledge base for understanding the underlying dynamics of condition and significance of therapeutic interventions.
Determine the likelihood for recurrence and long-term complications.	Certain underlying lung diseases such as severe COPD and malignancies may increase the incidence of recurrence. In otherwise healthy patients who suffered a spontaneous pneumothorax, incidence of recurrence is 10%–50%. Those who have a second spontaneous episode are at high risk for a third incident (60%).
Reassess signs and symptoms requiring immediate medical evaluation such as sudden chest pain, dyspnea or air hunger, progressive respiratory distress.	Recurrence of pneumothorax or hemothorax requires medical intervention to prevent or reduce potential complications.
Review the significance of good health practices (adequate nutrition, rest, exercise).	Maintenance of general well-being promotes healing and may prevent or limit recurrences.