Chest trauma
a. Flail chest Rationale The image depicts a ling during inspiration and indicates paradoxical breathing as the chest is sucked in during inspiration. This indicates flail chest. Cardia tamponade is a complication associated with the presence of excess fluid in the heart, which increases pressure on the heart. Iatrogenic pneumothorax is a type of chest trauma associated with a laceration on the lung that occurs during medical procedures. Traumatic pneumothorax is chest trauma associated with excess air in the chest cavity as a result of an opening in the chest wall.
Which chest is depicted in the accompanying image, as it occurs during patient inspiration? a. Flail chest b. Cardiac tamponade c. Iatrogenic pneumothorax d. Traumatic pneumothorax
Which size chest tube does the nurse have available for insertion for a patient who needs to have air drained from the chest? a. 14F b. 26F c. 36F d. 40F
a. 14F Rationale The chest tube size is 14F. Small tubes with a size in the range of 12F to 24F are used to drain air from the patient's chest. Medium tubes ranging from 24F to 36F are used for draining fluid from a patient's chest. Large tubes ranging from 36F to 40F are used for draining blood from the patient's chest.
A patient with fractured ribs asks why a thoracic binder is no longer recommended. The nurse explains that using a binder places the patient at risk for which complication? a. Atelectasis b. Chylothorax c. Hemopneumothorax d. Pulmonary embolism
a. Atelectasis Rationale The goal of treatment for fractured ribs is to decrease pain so that the patient can breathe adequately and clear secretions. Strapping the chest with tape or using a thoracic binder is not recommended. These limit chest expansion and predispose the person to atelectasis. Chylothorax is a complication of chest trauma, which results from the disruption of the thoracic duct. Hemopneumothorax is the presence of blood in the pleural cavity as a result of chest trauma. Pulmonary embolism is a blockage of a pulmonary blood vessel as a result of thrombus formation; this complication is not associated with the application of a binder.
The registered nurse is evaluating the actions of a nursing student who is maintaining a chest drainage unit (CDU) for a patient with chest trauma. The nurse intervenes when the student performs which actions? Select all that apply. a. Coils the tubing above the chest level b. Expects air fluctuations in the water-seal chamber c. Verifies the presence of an air-occlusive dressing over the insertion site d. Connects the chest tube to wall suction to check for tidaling e. Positions the tubing so that the drainage flows freely from the insertion site to the collection chamber
a. Coils the tubing above the chest level d. Connects the chest tube to wall suction to check for tidaling Rationale Coiling of the tubing above the chest level may cause fluid to drain back into the pleural cavity. Therefore the tubing of the drainage system should be coiled below the chest level. The chest tube should be disconnected from wall suction to check the tidaling because the suction will be increased. An absence of air fluctuations in the water-seal chamber indicates blockage of the tubing. The dressing of the drainage system should be air-occlusive to prevent leakage. The tubing should be dropped straight from the bed or chair to the drainage unit for easy flow.
Which condition in a patient with chest trauma requires treatment with positive pressure ventilation? a. Flail chest b. Cardiac tamponade c. Hemopneumothorax d. Tension pneumothorax
a. Flail chest Rationale Flail chest results in a loss of chest stability as a result of fracture of the ribs. The nurse should stabilize the flail segment with positive pressure ventilation (intubation and mechanical ventilation as needed). The nurse performs needle decompression to treat cardiac tamponade. The patient with a hemopneumothorax or tension pneumothorax requires treatment with chest tube drainage, and positive pressure ventilation aggravates the patient's condition.
The nurse provides care for a patient with a chest tube flutter valve in place and recalls which information about the device? a. It allows patient mobility. b. It is used to evacuate fluid from the pleural space. c. It is attached to the internal end of the chest tube. d. It opens when the chest pressure is less than the atmospheric pressure.
a. It allows patient mobility. Rationale A flutter valve (also called the Heimlich valve) is used to remove air from the pleural space. It allows for patient mobility because the smaller drainage bag can be hidden under the clothes while the patient ambulates. The valve evacuates air, not fluid, from the pleural space. It is attached to the external end of the chest tube. A flutter valve opens whenever the pressure in the chest is greater than the atmospheric pressure.
The nurse provides which information about the water-seal chamber on a chest drainage unit (CDU) when educating a group of nursing students? a. It contains 2cm of water. b. It acts as a two-way valve. c. It receives fluid and air from the pleural space. d. It applies suction to the drainage system.
a. It contains 2cm of water. Rationale The water-seal chamber is the second chamber of the chest drainage system. It contains 2 cm of water, which acts as a one-way valve. The first chamber of the drainage system receives fluid and air from the pleural space. The third chamber applies suction to the chest drainage system.
The nurse reviews the process for setting up a wet suction that is attached to a chest tube and questions which step that is listed in the procedure? a. Keep the suction control chamber uncovered b. Maintain the suction amount at -20 cm H2O pressure c. Dial the wall suction regulator to 80-120 mmHg d. Dial the wall suction regulator until there is a gentle bubbling in the suction control chamber
a. Keep the suction control chamber uncovered Rationale The nurse should keep the cover over the suction control chamber in place to prevent rapid evaporation of water and to decrease the noise of the bubbling. The ordered suction amount is generally at -20 cm H2O pressure. The nurse should dial the wall suction regulator until there is continuous gentle bubbling in the suction control chamber (generally 80 to 120 mm Hg)
A patient experiences a chest injury as a result of a motor vehicle accident. The patient's assessment findings include asymmetric chest excursion and an absence of breath sounds on the left side. Which condition does the nurse suspect? a. Left-sided pneumothorax b. Left-sided pleural effusion c. Pulmonary effusion (PE) d. Adult respiratory distress syndrome (ARDS)
a. Left-sided pneumothorax Rationale A pneumothorax should be suspected after any trauma to the chest wall. A pneumothorax is caused by air entering the pleural cavity. The pleural space has a few millimeters of lubricating fluid to reduce friction when the tissue moves. When air enters this space, the change in positive pressure causes a partial or complete lung collapse. As the volume of air in the pleural space increases, lung volume decreases. The patient described experienced a closed (no external wounds) pneumothorax. When the left part of a chest is crushed, breathing will be compromised, resulting in asymmetric excursion. On auscultation, breath sounds are absent over the affected area. PE is an abnormal collection of fluid in the pleural space. Clinical manifestations associated with PE include dyspnea, hypoxemia, tachypnea, cough, chest pain, hemoptysis, crackles, wheezes, fever, accentuation of pulmonic heart sound, tachycardia, and syncope. There is not enough information to conclude that ARDS has developed. The risk for ARDS is greater after the initial injury, not at the time of the injury.
Which type of surgery involves the removal of one lobe of the lung? a. Lobectomy b. Pneumonectomy c. Wedge resection d. Segmental resection
a. Lobectomy Rationale A lobectomy is a type of chest surgery that involves the removal of one lobe of the lung. A pneumonectomy is a type of chest surgery that involves the removal of an entire lung. A wedge resection is a type of surgery that involves the removal of only a small, localized lesion. A segmental resection is a type of surgery that involves the removal of one or more lung segments.
The nurse reviews the medical record of a patient with a pneumothorax and notes that the patient has a minimal amount of fluid accumulated in the intrapleural space and that the patient is stable. Which does the nurse infer? a. No treatment may be needed. b. The patient will require treatment with chest tube drainage. c. Treatment will include aspiration using a large-bore needle. d. The primary treatment plan will be needle decompression
a. No treatment may be needed. Rationale Treatment of a pneumothorax depends on its severity, its underlying cause, and the hemodynamic stability of the patient. If the patient is stable and has minimal air and/or fluid accumulated in the intrapleural space, no treatment may be needed because the condition may resolve spontaneously. Chest tube drainage is helpful to drain the fluid; however, this procedure is performed when the patient has severe complications. Aspiration with a large-bore needle is thoracentesis. This procedure is performed when the patient has fluid accumulation in the complete lung. Needle decompression helps to resolve pneumothorax when the patient has a medical emergency.
Following a thoracotomy, a patient uses patient-controlled analgesia (PCA). Which related outcome does the nurse expect? Select all that apply. a. The patient will have effective cough. b. The patient will be able to take deep breaths. c. The patient will have reexpansion of the lungs. d. The patient will have reduced pulmonary edema. e. The patient will be able to move the arm on the operative side.
a. The patient will have effective cough. b. The patient will be able to take deep breaths. e. The patient will be able to move the arm on the operative side. Rationale Thoracotomy is a painful procedure and involves cutting respiratory muscles during the surgery. Therefore the nurse administers patient-controlled analgesia (PCA) to alleviate pain. This will help the patient to cough effectively because there is a reduction in pain. Due to pain reduction, the strain on the lungs is reduced during breathing and the patient will be able to take deep breaths more easily. PCA will relieve pain and ease the movement of arm on the operative side. The chest tube placed on the chest after thoracotomy helps lung expansion. The nurse administers diuretics to relieve pulmonary edema.
A patient with a pneumothorax has a chest tube in place. The nurse verifies that there are no leaks in the tubing or at the insertion site. The nurse notes that there is no bubbling in the suction control chamber of the chest drainage unit (CDU). Which are the most probable reasons for the absence of bubbling? Select all that apply. a. There is no suctioning being applied b. The CDU is not working properly. c. The suction pressure is very low. d. The pleural air leak is so large that the suction in not high enough to evacuate it. e. There is a collection of blood in the pleural space.
a. There is no suctioning being applied c. The suction pressure is very low. d. The pleural air leak is so large that the suction in not high enough to evacuate it. Rationale If there is no bubbling in the suction control chamber, (1) there is no suction, (2) the suction is not high enough, or (3) the pleural air leak is so large that the suction is not high enough to evacuate it. A malfunctioning CDU is probably not the cause of the absence of bubbling. A collection of blood in the pleural space would be evident by the type of drainage.
The nurse provides information to a group of nursing students about wounds that result from penetrating trauma to the chest wall and includes which example? a. Wound caused by a gunshot b. Wound caused by a crush injury c. When the chest is struck by a baseball d. When the chest strikes a steering wheel
a. Wound caused by a gunshot
The nurse provides education for a patient about reducing the risk of atelectasis while undergoing chest tube drainage. Which statements made by the patient indicate effective learning? Select all that apply. a. 'I should change positions slowly." b. "I should cough at regular intervals." c. "I should use my incentive spirometer." d. "I should reduce the intake of protein in my diet." e. "I should perform range-of-motion exercises. "
b. "I should cough at regular intervals." c. "I should use my incentive spirometer." e. "I should perform range-of-motion exercises." Rationale Nursing care and patient teaching can minimize the risk of atelectasis. The nurse instructs the patient to change position slowly if he or she has hypotension. Protein is essential and does not reduce the risk of atelectasis.
Which intervention does the nurse perform 30 minutes before removing a chest tube from a patient? a. Prepare a sterile field that includes a petroleum dressing. b. Administer a pain medication to the patient. c. Clamp the chest tube. d. Ensure that the patient has nothing NPO.
b. Administer a pain medication to the patient.
How does splinting the incision with a pillow benefit a patient who underwent surgery to repair chest trauma? a. It reduces pain perception. b. It facilitates deep breathing. c. It reduces the risk of an air leak. d. It increases perfusion at the site.
b. It facilitates deep breathing. Rationale The patient will have difficulty breathing after surgery as a result of the incision on the chest. Splinting the incision facilitates deep breathing. The nurse administers analgesics to reduce pain. An occlusive dressing is applied over the site of surgery to reduce air leakage. The nurse instructs the patient to perform range-of-motion exercise to increase perfusion or oxygen supply to the injured site.
Which is a primary clinical manifestation of flail chest in an unconscious patient? a. Cyanosis b. Shallow respirations c. Neck vein distention d. Decreased heart rate
b. Shallow respirations Rationale An unconscious patient who has fractures of consecutive ribs will have rapid and shallow respirations. A flail chest is usually apparent on physical examination. The patient has rapid, shallow respirations and tachycardia. Movement of the thorax is asymmetric and uncoordinated. The patient may ventilate poorly and try to splint the chest to assist with breathing. Cyanosis may occur in a patient with impaired respirations; however, it is not an evident symptom of flail chest. The patient with flail chest will not have edema, so distention of the neck is not a manifestation. The patient with flail chest will have an increased heart rate (tachycardia)
After connecting a patient's chest tube to a dry suction system, which action does the nurse take next? a. Verify that the float has disappeared from the window of the chest drainage unit (CDU). b. Turn the suction dial on the CDU to -20 cm H2O pressure. c. Depress the high-negativity vent. d. Briefly and methodically move clamps down the chest tube to assess for air leaks
b. Turn the suction dial on the CDU to -20 cm H2O pressure. Rationale After connecting the patient to the system, the nurse should turn the dial on the chest drainage system to the amount ordered (generally -20 cm H2O pressure). The nurse then should connect the suction tubing to the wall suction source and increase the suction until the float appears in the window of the CDU. If ordered to decrease the suction, the nurse would turn the dial down, depress the high-negativity vent, and assess for a rise in the water level of the water-seal chamber. Brief and methodical clamping should take place if an air leak is suspected; there is no information given that warrants this action.
Which surgical lung procedure involves the removal of a small, localized lesion that occupies only part of a segment? a. Pleurodesis b. Wedge resection c. Pleural biopsy d. Thoracentesis
b. Wedge resection Rationale A wedge resection is the removal of a small, localized lesion that occupies only part of a segment. Pleurodesis is the surgical procedure that helps in the adhesion of the visceral and parietal pleura in the patient who has a pneumothorax. Pleural biopsy is a procedure in which a sample of pleural cells is examined for tumors. Thoracentesis is a procedure that is performed to drain the fluid from the pleural space.
Which instruction does the nurse give to a patient when removing the patient's chest tube? a. "Lie on the side that is the opposite of the chest tube." b. "Take some deep breaths throughout the procedure." c. "Bear down while the tube is being removed." d. "Drink a large amount of water just before the procedure."
c. "Bear down while the tube is being removed." Rationale Chest tubes are removed when the lungs are reexpanded and fluid drainage has ceased or is minimal. The patient should hold his or her breath or bear down (Valsalva maneuver) while the tube is removed to prevent air from entering the pleural space. Instructing the patient to lie on his or her side will reduce lung expansion. As a result, the patient's condition may be aggravated. Instructing the patient to take deep breaths throughout the procedure will increase the risk of air entering the pleural space, causing a pneumothorax. There is not need for the patient to consume an increased amount of water before the procedure.
The registered nurse mentors a new graduate nurse. The new graduate nurse provides care for a patient who has a chest tube in place after a partial lobectomy. Which action by the new graduate requires the mentor to intervene? a. Positioning the patient in a semi-Fowler's position b. Encouraging the patient to increase his fluid intake c. Clamping the chest tube while the patient is ambulating to the bathroom d. Administering the patient's prescribed narcotic analgesic before activity
c. Clamping the chest tube while the patient is ambulating to the bathroom Rationale Clamping of chest tubes is generally contraindicated. Clamping would allow a build-up of secretions or air in the pleural space and inhibit lung expansion. Patients with chest tubes are usually placed in the semi-Fowler's position for the sake of comfort and ease of breathing. Fluid intake is not a major concern in light of the information provided. Administering the patient's prescribed narcotic analgesic before activity is an expected standard of care for this patient.
The nurse notes that a patient's treatment plan for chylothorax includes chemical pleurodesis. The nurse expects that which medication will be prescribed? a. Octreotide b. Prednisone c. Doxycycline d. Cyclosporine
c. Doxycycline Rationale Chylothorax is the presence of lymphatic fluid in the pleural space. The thoracic duct is disrupted either traumatically or from cancer, allowing lymphatic fluid to fill the pleural space. Chemical pleurodesis is done to obliterate the pleural space and prevent reaccumulation of effusion fluid. This procedure first requires chest tube drainage of the effusion. Once the fluid is drained, a chemical slurry is instilled into the pleural space. Talc is the most effective agent for pleurodesis. Other agents that can be used include doxycycline and bleomycin. Octreotide is a hormone-like drug that acts as a vasoconstrictor (somatostatin) and reduces lymphatic flow; however, this medication is not used after pleurodesis. Prednisone is a corticosteroid used to reduce the progression of chronic pulmonary fibrosis. Cyclosporin is an immunosuppressive drug that treats pulmonary fibrosis.
Which type of chest surgery is indicated for a patient with chest trauma? a. Pneumonectomy b. Segmental resection c. Exploratory thoracotomy d. Lung volume reduction surgery
c. Exploratory thoracotomy Rationale An exploratory thoracotomy is an incision into the thorax to look for injured or bleeding tissues. It is indicated for a patient with chest trauma. Pneumonectomy is indicated for a patient with lung cancer. Segmental resection is indicated for a patient with bronchiectasis. Lung volume reduction surgery is indicated for a patient with advanced bullous emphysema.
A patient has a chest tube inserted to treat a pneumothorax. Which observation causes the nurse to conclude that the water-seal chamber of the chest drainage unit (CDU) is functioning properly? a. There is no bubbling in the suction control chamber b. The wall suction regulator is set to 150 mmHg. c. The level in the water-seal chamber fluctuates with respirations. d. There is bloody drainage present in the water-seal chamber.
c. The level in the water-seal chamber fluctuates with respirations. Rationale The water-seal chamber level fluctuates with respirations as a result of the restoration of negative pressure within the thoracic cavity. If there is no bubbling in the suction control chamber, (1) there is no suction, (2) the suction is not high enough, or (3) the pleural air leak is so large that the suction is not high enough to evacuate it. The wall suction regulator should be set until there is continuous gentle bubbling in the suction control chamber (generally 80-120 mmHg). The water-seal chamber should not contain blood; this finding indicates that the chest tube drainage system may have overturned and should be replaced.
A patient experiences a sucking chest wound as a result of surgical thoracotomy. Which type of pneumothorax does the nurse suspect? a. Tension b. Iatrogenic c. Traumatic d. Spontaneous
c. Traumatic Rationale A penetrating wound of the chest may be referred to as a sucking chest wound because air enters the pleural space during inspiration through the chest wall. A surgical thoracotomy can cause sucking chest wounds and result in traumatic pneumothorax. A tension pneumothorax is the condition associated with the accumulation of air in the pleural space, resulting in lung compression. An iatrogenic pneumothorax is the result of trauma to the chest wall that occurs during a medical procedure such as a thoracentesis. A spontaneous pneumothorax is chest wall trauma that is associated with the rupture of small blebs.
Which is the reason that the nurse, while assisting with insertion of a chest tube, positions the patient with the arm raised above the head on the affected side? a. To minimize pain b. To reduce the risk of injury c. to expose the midaxillary area d. To avoid the intercostal nerves
c. to expose the midaxillary area Rationale The midaxillary area is the standard site for the insertion of a chest tube. Therefore the nurse will position the patient with the arm raised above the head on the affected side to expose the midaxillary area. Analgesics will be given to the patient to minimize pain. The patient's head will be elevated to reduce the risk of injury. The chest tube will be advanced up over the rib to avoid the intercostal nerves.
The nurse provides care for a patient who experienced chest trauma. When the nurse assesses the right lung, which finding suggests a right-sided pneumothorax? a. Inspiratory crackles b. Pronounced crackles c. Dullness on percussion d. Absence of breath sounds
d. Absence of breath sounds Rationale A pneumothorax indicate that one of the lungs has collapsed and is not functioning. Manifestations of a pneumothorax includes dyspnea, decreased movement of the involved chest wall, decreased or absent breath sounds on the affected side, and hyperresonance on percussion. Because no air movement occurs with a pneumothorax, no breath sounds, including crackles, will be heard. Assessment finding will include hyperresonance on percussion.
A patient presents with a traumatic hemothorax. Which immediate action does the nurse take? a. Call the Code Blue team. b. Administer and autotransfusion. c. Assist the health care provider with needle decompression. d. Assist the health care provider in inserting a chest tube.
d. Assist the health care provider in inserting a chest tube. Rationale A hemothorax is an accumulation of blood in the pleural space resulting from injury to the chest wall, lung, blood vessels, diaphragm, or mediastinum. The patient with a traumatic hemothorax needs immediate insertion of a chest tube for evacuation of the blood. The Code Blue team is called if a patient experiences a respiratory or cardiac arrest. An autotransfusion cannot occur until the blood has been collected in the chest drainage unit (CDU). A needle decompression is the treatment for a tension pneumothorax.
A patient with chest wall trauma has diminished breath sounds on the affected side, dyspnea, and bleeding in the chest wall. A chest tube is inserted immediately after the injury. Which diagnosis does the nurse expect to find in the patient's medical record? a. Flail chest b. Chylothorax c. Cardiac tamponade d. Hemopneumothorax
d. Hemopneumothorax Rational A hemopneumothorax is an accumulation of blood in the pleural space from injury to the chest wall, diaphragm, lung, blood vessels, or mediastinum. When it occurs with pneumothorax, it is called a hemopneumothorax. A hemopneumothorax in a patient with a chest wall injury is manifested by diminished breath sounds on the affected side and dyspnea and bleeding in the chest wall. Flail chest is a thoracic injury associated with fracture of the ribs. Chylothorax is a thoracic injury and is characterized by the presence of lymph in the pleural space. Cardiac tamponade is associated with increased pleural fluid in the pericardium, which increases pressure on the heart.
Which immediate action does the nurse take when discovering that a patient's chest tube is disconnected from the chest drainage unit (CDU)? a. Apply a clamp to the distal end of the chest tube. b. Place the patient in a supine position. c. Wrap a petroleum (airtight) gauze over the end of the chest tube. d. Immerse the distal end of the chest tube in the sterile water.
d. Immerse the distal end of the chest tube in the sterile water. Rationale If the drainage system breaks, the nurse should place the distal end of the chest tubing connection in a sterile water container at a 2-cm level as an emergency water seal. This will reduce the risk of air entering the pleural space. Applying a clamp to the tube will accumulate fluid or air in the pleural space. There is no information given related to respiratory status to determine correct patient positioning. Wrapping a petroleum (airtight gauze over the end of the chest tube will accumulate fluid or air in the pleural space.
A patient with chest trauma has a chest tube in place. Upon entering the patient's room, the nurse notes that the chest tube is completely broken at the midpoint and is no longer attached to the drainage unit. Which action does the nurse take? a. Milks the drainage tube b. Strips the drainage tubes c. Empties the collection chamber d. Places the tubing in a sterile water container
d. Places the tubing in a sterile water container Rationale The drainage system should be properly checked to lessen the risk of complications. If the drainage system is found to be broken, then the distal end of the chest tubing connection should be placed in a sterile water container at a 2-cm level as an emergency water seal. Milking and stripping the drainage tubes are done only when there is an order from the physician. the collection chamber should never be emptied but should be replaced.
A patient with a diagnosis of chylothorax is prescribed octreotide. Which outcome does the nurse expect after the treatment? a. adequate hydration b. Adequate pain control c. Reduced risk of hypoxemia d. Reduced flow of lymphatic fluid
d. Reduced flow of lymphatic fluid Rationale Chylothorax is a type of chest injury that is associated with the accumulation of fluid in the pleural space. Octreotide acts like the natural hormone somatostatin, which behaves as a vasoconstrictor and reduces the flow of lymphatic fluid into the pleural space. The patient with chylothorax will not need hydration and IV fluids. The nurse administers analgesia for adequate pain control. Octreotide does not reduce the risk of hypoxemia.
The nurse provides teaching for a patient who is scheduled for a bedside thoracentesis. Which does the nurse explain as the primary purpose of the procedure? a. Determining the stage of lung tumor b. Directly inspecting and examining the pleural space c. Obtaining a specimen of pleural tissue for evaluation d. Relieving an abnormal accumulation of fluid in the pleural space
d. Relieving an abnormal accumulation of fluid in the pleural space Rationale Thoracentesis involves the insertion of a large-bore needle into the pleural space to relieve an abnormal accumulation of fluid in the pleural space. The procedure can significantly relieve symptoms related to this fluid accumulation, such as shortness of breath and discomfort. Thoracentesis cannot reveal the stage of lung cancer or permit direct inspection and examination of the pleural space. It may provide a pleural fluid specimen but not a pleural tissue specimen.
A patient with an iatrogenic pneumothorax has a chest tube that is connected to a chest drainage unit (CDU). The nurse assesses swelling in the head and neck and a compromised airway. The nurse suspects which complication? a. pleurisy b. Atelectasis c. Cor pulmonale d. Subcutaneous emphysema
d. Subcutaneous emphysema Rationale Subcutaneous emphysema can occur from air leaking into the tissue surrounding the chest tube insertion site. A "crackling" sensation will be felt when palpating the skin. A small amount of subcutaneous air is harmless and will be reabsorbed. However, severe subcutaneous emphysema can cause drastic swelling of the head and neck with potential airway compromise. Pleurisy is characterized by an inflammation in the pleura as a result of infection, which results in rapid and shallow breathing. Atelectasis is associated with the absence of breath sounds and collapsed lungs. Cor pulmonale is a disorder of the respiratory system associated with enlargement of the right ventricle.
Which type of procedure allows the health care provider to manipulate instruments passed into the pleural space? a. Decortication b. Segmental resection c. Exploratory thoracotomy d. Video-assisted thoracoscopic surgery
d. Video-assisted thoracoscopic surgery Rationale Video-assisted thoracoscopic surgery allows the surgeon to manipulate instruments passed into pleural space. Decortication, segmental resection, and exploratory thoracotomy do not allow the surgeon to manipulate instruments passed into pleural space.
