Understanding Tension Pneumothorax: A Critical Insight for CFRN Exams

You have a 25-year-old male patient who was involved in a motorcycle crash. He shows absent lung sounds on the right. What other sign would indicate a tension pneumothorax?

• A. Hypertension
• B. Bradycardia
• C. Hypotension
• D. Muffled Heart Tones

Answer: (C)

In the context of a tension pneumothorax, the presence of absent lung sounds on one side, such as on the right in this scenario, indicates a buildup of air in the pleural space that is compressing the lung. This compression gradually compromises respiratory and circulatory function, leading to a series of physiological changes. Hypotension is a critical sign associated with tension pneumothorax. As the pressure in the pleural space increases, it not only restricts lung expansion but can also exert pressure on the mediastinum, which includes the heart and great vessels. This can lead to compromised venous return to the heart and result in decreased cardiac output. Consequently, the blood pressure drops and the patient can exhibit signs of shock, hence hypotension. In tension pneumothorax cases, the shift of the mediastinum away from the affected side can further obstruct blood flow, exacerbating the hypotensive state, and may lead to cardiovascular collapse if not swiftly addressed. Hypertension might occur if the body attempts to compensate for reduced blood flow or if other factors are involved, but it is not a definitive sign. Bradycardia can sometimes occur in advanced stages of shock but isn't directly indicative of tension pneumothorax. M

Tension pneumothorax can be a challenging topic to wrap your head around, but it's vital for any aspiring Certified Flight Registered Nurse (CFRN). Picture this: you're faced with a 25-year-old male who has just been involved in a motorcycle crash. Already, your mind is racing through the critical assessments you need to make. Alarming absent lung sounds on the right signal there's something deeply amiss. Now, you have to identify the signs of a tension pneumothorax. What else should you look for? Honestly, hypotension is a big flag here. Why? Let me explain!