NCLEX RN Practice Question # 400

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Flail chest
1.Description
- Occurs fromblunt chest traumaassociated with accidents, which may result in hemothorax and rib fractures.
- The loose segment of the chest wall becomes paradoxical to the expansion and contraction of the rest of the chest wall
- 2. Assessment
- Paradoxical respirations (inward movement of a segment of the thorax during inspiration with outward movement during expiration)
- Severe pain in the chest
- Dyspnea
- Cyanosis
- Tachycardia
- Hypotension
- Tachypnea, shallow respirations
- Diminished breath sounds
- Interventions
- Place the client in a Fowler’s position.
- Administer humidified oxygen as prescribed.
- Monitor for increased respiratory distress.
- Encourage coughing and deep breathing.
- Administer pain medication as prescribed.
- Maintain bed rest and limit activity to reduce oxygen demands.
- Prepare for intubation with mechanical ventilation, with positive end-expiratory pressure
- (PEEP) for severe flail chest associated with respiratory failure and shock.