Chapter 22, Problem 4CCS

35-Year-Old Female with Chest Trauma

Barbara Joley was in a major car accident. When EMS managed to free her from the wreckage, she was cyanotic and apneic (not breathing). Her heart was still beating, but her pulse was fast and thready. The emergency medical technician reported that when Barbara was found, her head was cocked at a peculiar angle and it looked like she had a fracture at the level of the C₂ vertebra. The following questions refer to these observations.

4.NCLEX-STYLE How do Barbara's recorded injuries relate to the pneumothorax?

a. The pain from her broken ribs is causing her to decrease breathing, so the right lung is not inflating.

b. Barbara’s fractured ribs probably punctured her lung tissue and allowed air within the lung to enter the pleural cavity.

c. When the level of O₂ in the blood decreases, a negative feedback loop involving the central chemoreceptors causes lung inflation to decrease as well.

d. Her traumatic injury has caused her peripheral chemoreceptors to stop working, so they are not causing her to increase ventilation.