a. Flail chest
174. Which assessment data would support the conclusion that the client had likely developed a pneumothorax?
a. Sudden, sharp pain in the chest that increases on inspiration
b. Production of blood-streaked sputum
c. Stridor with diaphoresis
d. Prolonged inspiration with wet rales
173. Correct answer: a.
Flail chest occurs when multiple contiguous ribs are fractured in more than one place resulting in free-floating rib pieces. This free-floating section is pulled in during inspiration and bulges outward during expiration (paradoxical movement) impeding both intake and outflow of air from the lungs. Paradoxical movement does not occur with atelectasis, pneumonia, or hemothorax. With atelectasis, there are decreased breath sounds over the affected area. With a large hemothorax, decreased chest movement on the affected side and decreased or absent breath sounds occur.
174. Correct answer: a.
Sudden, sharp chest pain that increases on inspiration and unilaterally diminished breath sounds are classic signs of pneumothorax. Blood-streaked sputum, stridor,
diaphoresis, prolonged inspiration, and wet rales are not S&S of pneumothorax.