Question

8.) A client presents to the emergency department with hypotension, hypoxemia, and tracheal deviation to the left following a motor vehicle accident (MVA). There is massive bruising on the chest, and a large open wound. What is the most likely diagnosis?

only one correct answer

1.) Spontaneous pneumothorax

2.) Pleural effusion

3.) Tension pneumothorax

4.) Pleuritis

Answer 1

Tension pneumothorax is the most appropriate diagnosis.lf tension pneumothorax develops, the patient becomes hypoxemic and hypotensive as well.The trachea may deviate to the unaffected side.Heart sounds may be muffled. Bradycardia and shock occur if emergency intervention is not provided. If a pneumothorax is closed, air, and therefore tension, buids up in the pleural space and is unable to escape. As tension increases pressure is placed on the heart and great vessels, pushing them away from the affected side of the chest.This is called a mediastinal shift.When the heart and vessels are compressed, venous return to the heart is impaired, resulting in reduced cardiac output and symptoms of shock.

In this case also client having hypotension, hypoxemia, tracheal deviation to the left, a massive bruising on the chest and a large open wound so Tension pneumothorax is evident.