# The patient demonstrates ______ breathing, where breathing effort increases but chest wall and abdomen move in opposite directions.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168394  
> language: ko  
> subject: Diseases of the respiratory system

## 문제

The patient demonstrates ______ breathing, where breathing effort increases but chest wall and abdomen move in opposite directions.

## 보기

1. paradoxical **✔ 정답**
2. labored
3. agonal
4. Cheyne-Stokes
5. Kussmaul

**정답: 1**

## 해설

Paradoxical breathing occurs when the chest wall moves inward during inspiration while the abdomen moves outward, or vice versa. This abnormal pattern can indicate severe respiratory distress, chest wall injury, or neuromuscular weakness.

## 임상 시나리오

Paradoxical Breathing:
- Definition: Asynchronous movement between chest wall and abdomen during respiration
- Causes: Flail chest, diaphragm dysfunction, severe COPD
- Clinical signs: Inward chest movement during inspiration, outward abdominal movement
- Associated conditions: Trauma, neuromuscular disorders, respiratory failure
- Assessment: Observe chest wall motion, respiratory rate, work of breathing
- Complications: Respiratory insufficiency, hypoxemia, respiratory failure
- Treatment: Address underlying cause, mechanical ventilation if needed
- Diagnostic tools: Physical examination, chest X-ray, CT scan
- Emergency indicators: Increased respiratory distress, cyanosis, altered consciousness
- Prevention: Protect chest wall during trauma, early treatment of respiratory conditions

## 핵심 개념

- **paradoxical** — A breathing pattern where the chest wall and abdomen move in opposite directions during respiration, indicating severe respiratory distress or chest wall injury
- **labored** — Breathing that requires increased effort and energy, often characterized by the use of accessory muscles and visible signs of respiratory difficulty
- **agonal** — Gasping, irregular breathing pattern that occurs in severely ill patients, often indicating imminent death or severe brain dysfunction
- **Cheyne-Stokes** — A cyclical pattern of breathing characterized by periods of deep, rapid breaths followed by periods of shallow breathing or complete pause in breathing
- **Kussmaul** — Deep and labored breathing pattern characterized by increased rate and depth of respiration, often associated with metabolic acidosis

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