NCLEX RN Practice Question # 400

Flal chest
Flail chest

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Flail chest


  • 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
  1. 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.


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