ECOLOGIC MODEL

A. HYPOTHESIS

Hemopneumothorax, is a medical term describing the combination of

two conditions: pneumothorax, or air in the chest cavity,
and hemothorax (also called hæmothorax), or blood in the chest cavity.

In the case of our client, she was shot by a 9mm gun causing a blunt
or penetrating injury to the thorax, resulting in a rupture of the serous
membrane either lining the thorax or covering the lungs. This rupture allows
blood to spill into the pleural space, equalizing the pressures between it and
the lungs. The client experienced gasping of breath and nearing to lose
consciousness and she was bleeding profusely.

A chest tube thoracotomy was immediately secured in place at right

chest.

B. PREDISPOSING FACTORS
a. Host
• Sex: Female
• Age: 37 years old
• Status: Married
b. Agent
• Mechanical – the client had a gunshot wound by a 9mm gun
- she has a chest tube thoracotomy located at right
chest
c. Environment
• Occupation: Self- Employed
• Place of Work: Balayan, Batangas
• Address: Balayan, Batangas
 C. ECOLOGIC MODEL

HOST

Environment Agent

D. ANALYSIS

The agent-host-environment model is primarily use in predicting illness

rather than promoting wellness, although identification of risk factors that result
from the interactions of agent, host, and environment are helpful in promoting
and maintaining health. Because each of the agent-host-environment factors
constantly interacts with others, health is an ever changing state. Health is seen
when all three elements are in balance while illness is seen when one, two, or all
three elements are not in balance
(Fundamentals of Nursing by Kozier 2004)

Any blunt or penetrating injury to your chest can cause

hemopneumothorax. Knife and gunshot wounds can cause a
hemopneumothorax. So injuries that unintentionally occur during certain medical
procedures such as the insertion of chest tubes, cardiopulmonary
resuscitation (CPR) and lung or liver biopsies. Pneumohemothorax is a life-
threatening condition that results from a progressive deterioration and worsening
of a simple pneumothorax, associated with the formation of a one-way valve at
the point of a rupture in the lung. Air becomes trapped in the pleural cavity
between the chest wall and the lung, and builds up, putting pressure on the lung
and keeping it from inflating fully.
(http://en.wikipedia.org/wiki/Hemopneumothorax)
 E. CONCLUSION

We therefore conclude that the client is suffering from

pneumohemothorax. The patient presented falls in the category of penetrating
injuries. She was shot, causing a laceration on her right chest, where she was
immediately secured with a chest tube thoracotomy.

F. RECOMMENDATION

The goal in treating a pneumothorax is to relieve the pressure on the lung,

allowing it to re-expand, and to prevent recurrences. The best method for
achieving this depends on the severity of the lung collapse and sometimes on the
overall health of the client.
Treatment for this condition is the same as for hemothorax and
pneumothorax independently: by tube thoracotomy, the insertion of a chest
drain through an incision made between the ribs, into the intercostal space. A
chest tube must be inserted to drain blood and air from the pleural space so it
can return to a state of negative pressure and function normally. Commonly,
surgery is needed to close off whatever injuries caused the blood and air to enter
the cavity (e.g. gunshot, broken ribs).