A client arrives with asymmetrical chest wall expansion during respiration after a motor vehicle collision. What action should the nurse implement next?

A client arrives with asymmetrical chest wall expansion during respiration after a motor vehicle collision. What action should the nurse implement next?

• A. Apply a chest tube immediately
• B. Auscultate the lungs bilaterally
• C. Initiate CPR
• D. Administer IV fluids

Answer: (B)

In trauma care, the priority is to assess breathing to identify potentially life-threatening chest injuries. When chest wall expansion is uneven, the next essential step is to listen to both lungs to evaluate air entry on each side. Auscultating the lungs bilaterally reveals whether breath sounds are present and equal; absent or markedly diminished sounds on one side suggest a pneumothorax or hemothorax (or other lung injury), which guides urgent imaging and management decisions, including potential chest tube if a pneumothorax or large effusion is confirmed. Initiating a chest tube right away isn’t appropriate without confirming the problem. CPR is due only if there’s no pulse, and IV fluids aren’t the immediate action driven by asymmetric chest expansion alone. So, the best next step is to auscultate both lungs to assess ventilation and guide further care.

In trauma care, the priority is to assess breathing to identify potentially life-threatening chest injuries. When chest wall expansion is uneven, the next essential step is to listen to both lungs to evaluate air entry on each side. Auscultating the lungs bilaterally reveals whether breath sounds are present and equal; absent or markedly diminished sounds on one side suggest a pneumothorax or hemothorax (or other lung injury), which guides urgent imaging and management decisions, including potential chest tube if a pneumothorax or large effusion is confirmed. Initiating a chest tube right away isn’t appropriate without confirming the problem. CPR is due only if there’s no pulse, and IV fluids aren’t the immediate action driven by asymmetric chest expansion alone. So, the best next step is to auscultate both lungs to assess ventilation and guide further care.