Learning Assessment no.

1. The patient’s Jugular vein have been cut, he’s bleeding and is not currently breathing. The left
lung is in distress and there were numerous lacerations including the penetrated glass in the
patient’s left lower quadrant. Due to the accident, the patient suffered from tension
pneumothorax. It is a life-threatening condition that develops when air is trapped
in the pleural cavity under positive pressure, displacing mediastinal structures
and compromising cardiopulmonary function.

2. The procedure done to the patient is similar to Closed-chest drainage. Dr. Murphy made a
homemade one way valve through the use of a knife, a narrow, 6-foot tube, high-proof alcohol,
gloves and baggage handling tape. After sterilizing and assembling the equipments, he lacerated
the part where the tube would be inserted. He successfully made a one-bottle system and saved
the boy’s life because the tube allows the air to get out and the water in the bottle stops the air
from coming back in. This procedure is also known as thoracentesis or thoracostomy.
3. Dr. Murphy performed the closed chest drainage because they are used to remove air or
fluids from the pleural space. The patient who is experiencing a tension
pneumothorax have air or fluids trapped in their plural cavity should have
immediate response because this can lead to a very serious condition such
as shock or even death due to compression of the lungs and decrease
venous return to the heart. The closed-chest drainage, one-bottle system is
the best intervention for this situation because it is the simplest and most
effective especially in emergency cases like this where the resources were
very limited.
4. Dr. Murphy’s initial diagnosis is Tension Pneumothorax. His basis or
assessment for coming up with the said diagnosis were the absence of breath
sounds on the affected site, hypoxia, venous distention and shock.
5. When the patient is brought to the hospital, the patient should undergo x-ray or CT Scan to
know if there where organs affected by the lacerations, broken bones or trauma due to the
impact. Chest x-ray should also be done to confirm expansion of the lung and proper
placement of the chest tube. The patient can also undergo Ultrasound imaging because it is
also used to identify a pneumothorax. Vital signs should also be monitored closely because it
determines the patient’s stability and when there’s another damage or injury that was detected,
the accurate diagnostic procedure for that will be made thereafter.
6. With the skills and knowledge that I have gained as a nurse, if I were be put in that situation,
since the patient is experiencing tension pneumothorax, I will sanitize the body part with the use
of alcohol or betadine because that is more accessible. Then I will do the needle decompression
because it is also an effective way to allow air escape the pleural cavity. Since this is an easier
procedure, we can save more time and help the patient quicker.
7. If I will meet the patient in the emergency room after the first-aid intervention of Dr. Murphy, I
will get the complete medical history of the patient and perform brief examination such as vital
 signs taking and physical assessment to determine the severity of the patient’s condition. Then I
have to gather personal information of the patient and obtain consent for treatment. Then, I can
begin to the initial treatments that my patient needs until the doctor arrives and takes over.

The patient should be given ordered medications by the physician such as analgesics to reduce the pain
that the patient is feeling or anesthetics if the patient needs to undergo surgery. Recommended amount
of antibiotics can also be administered to prevent infection due to the use of unsterile equipments and
unsterile environment. Tetanus Toxoid Injection should also be given to prevent getting
a disease called tetanus especially since the child have numerous lacerations.
Giving vitamins and other immune boosters were also recommended especially that
the patient is a child and it will help him in faster wound healing and increase the
production of white blood cells, which are key to fighting infections.