Trauma Nurse Core Course (TNCC) Practice Exam

Which of the following is a possible complication of positive-pressure ventilation?

1. Worsening pneumothorax

2. Worsening flail chest

3. Reabsorption of pleural air

4. Negative intrapleural pressure

The correct answer is: Worsening pneumothorax

Positive-pressure ventilation can lead to a worsening pneumothorax because this type of ventilation increases intrathoracic pressure. When pressure is elevated in the thoracic cavity, it can cause direct pressure on the lung tissue, potentially exacerbating the condition if air has already escaped into the pleural space through a rupture or injury. This can lead to further collapse of the lung. In patients with a pre-existing pneumothorax, the addition of positive pressure can cause more air to enter the pleural space, worsening respiratory status. Understanding this complication is crucial for trauma nurses, as it underscores the importance of monitoring patients closely when administering positive-pressure ventilation, particularly those with suspected or confirmed thoracic injuries. Monitoring for changes in breath sounds, respiratory distress, and imaging studies (like chest X-rays) can help identify any exacerbation of a pneumothorax early on, allowing for timely intervention.