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Chapter 94: Pneumothorax Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient with a central line develops respiratory compromise. What is the initial intervention for this patient?

a. Lung ultrasonography (US) to determine the cause b. Obtaining cultures and starting antibiotics c. Prompt removal of the central line d. Rapid assessment and resuscitation

ANS: D a. Needle aspiration of the pneumothorax b. Observation for spontaneous resolution c. Placement of a small-bore catheter d. Tube thoracostomy

Patients with central lines are at increased risk for pneumothorax. Acute respiratory distress is a medical emergency and assessment and resuscitation should begin immediately. Lung US, cultures and antibiotics, and removal of the central line may be performed if indicated when the patient is stabilized.

2. Which method of treatment is used to manage a traumatic pneumothorax?

ANS: D

Traumatic pneumothorax requires tube thoracostomy because of its ability to drain larger volumes of air along with blood and fluids. Needle aspiration is safe for primary pneumothorax. Observation for spontaneous resolution is indicated for small pneumothoraces.

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