The nurse is caring for a patient who sustained rib fractures after hitting the steering wheel of his car.The patient is spontaneously breathing and receiving oxygen via a face mask; the oxygen saturation is 95%.During the nurse's assessment,the oxygen saturation drops to 80%.The patient's blood pressure has dropped from 128/76 mm Hg to 84/60 mm Hg.The nurse assesses that breath sounds are absent throughout the left lung fields.The nurse notifies the physician and anticipates:

Question

Quizplus · Accepted Answer

These are classic symptoms of a tension pneumothorax in a patient at high risk related to mechanism of injury.Emergent decompression by a needle thoracostomy followed by a chest tube insertion is needed.A chest x-ray would delay treatment and is not needed prior to emergent intervention.Administration of IV fluids would not assist with blood pressure,as increased thoracic pressure from the tension pneumothorax needs to be relieved to restore cardiac output (and blood pressure).Endotracheal intubation and mechanical ventilation may be necessary after the tension pneumothorax is relieved to assist with the patient's ventilation.

The Nurse Is Caring for a Patient Who Sustained Rib