A 28-year-old male is brought to the emergency department af… | MyMerci
Physiological Adaptation PA
Question

A 28-year-old male is brought to the emergency department after a motor vehicle collision. He is tachypneic, using accessory muscles, and has tracheal deviation to the right. Breath sounds are absent on the left. Heart rate is 130/min, blood pressure is 82/50 mm Hg, and oxygen saturation is 86% on room air. Which action should the nurse take first?

Explanation
The patient’s presentation—severe respiratory distress, tracheal deviation, absent breath sounds on the left, hypotension, and tachycardia—is classic for tension pneumothorax, a life-threatening emergency. Immediate needle decompression is the priority to relieve pressure and restore cardiac output; waiting for a chest x-ray delays definitive treatment and risks cardiac arrest. Administering oxygen alone does not address the underlying air trapping, and fluid resuscitation, while potentially needed for hypotension, is secondary to decompression. The nurse must recognize obstructive shock and prepare for emergent decompression without delay.
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