The therapist is assessing a newborn on the mechanical ventilator. The neonate shows clear signs of respiratory distress, and lung auscultation reveals shifting of the PMI toward the left and breath sounds decreased on the right. What should the therapist suspect this newborn developed?

Question

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Neonates with spontaneous pneumothorax may be asymptomatic or have mild signs of tachypnea with increased oxygen requirement. Occasionally, severe respiratory distress (grunting, nasal flaring, and intercostal retractions) may occur. In the ventilated neonate, pneumothorax may result in a rapid clinical deterioration with cyanosis, hypotension, hypoxemia, hypercapnia, and respiratory acidosis. In unilateral pneumothorax, breath sounds may be decreased on the ipsilateral side and the cardiac apex can be shifted toward the contralateral side. Some infants can develop distention of the involved hemithorax or a tensely distended abdomen from downward displacement of the diaphragm. In the event of a tension pneumothorax, signs of shock can occur as a result of increased intrathoracic pressure that compromises venous return and decreases cardiac output.

The Therapist Is Assessing a Newborn on the Mechanical Ventilator