NCLEX RN Practice Question # 651

NCLEX Examination.

Practice Question # 651.


What is Flail chest?


  • Occurs from blunt chest trauma associated 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.
Dyspnea. Chest pain. Paradoxical chest wall movement. Poor air movement. Crepitus. Hypoxia. Cyanosis.

Assessment Findings:

  • 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

Nursing Interventions:

  • Maintain the client in a Fowler’s position.
  • Administer 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 PEEP for severe flail chest associated with respiratory failure and shock.

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