A client was not using his seat belt when involved in a car accident. He fractured ribs 5, 6, and 7 on the left and developed a left pneumothorax.

A client was not using his seat belt when involved in a car accident. He fractured ribs 5, 6, and 7 on the left and developed a left pneumothorax.

Assessment findings include:
A . Crackles and paradoxical chest wall movement
B . Decreased breath sounds on the left and chest pain with movement
C . Rhonchi and frothy sputum
D . Wheezing and dry cough

View Answer

Answer: B

Explanation:

(A) Crackles are caused by air moving through moisture in the small airways and occur with pulmonary edema. Paradoxical chest wall movement occurs with flail chest when a segment of the thorax moves outward on inspiration and inward on expiration.

(B) Decreased breath sounds occur when a lung is collapsed or partially collapsed. Chest pain with movement occurs with rib fractures.

(C) Rhonchi are caused by air moving through large fluid-filled airways. Frothy sputum may occur with pulmonary edema.

(D) Wheezing is caused by fluid in large airways already narrowed by mucus or bronchospasm. Dry cough could indicate a cardiac problem.