What vital sign changes should the nurse expect in a patient with tension pneumothorax?

In the case of tension pneumothorax, a critical condition where air accumulates in the pleural space leading to increased pressure and impaired respiratory and cardiovascular function, several vital sign changes can typically be observed.

Progressive tachycardia is expected due to the body's compensatory response to decreased cardiac output and hypoxia. As the pressure in the pleural space builds, it can compress the lung and the mediastinum, leading to decreased venous return to the heart. The heart compensates by increasing the heart rate to maintain adequate perfusion.

A decrease in PaCO2 may occur initially as a result of hyperventilation due to hypoxia. However, in more severe cases or later stages, retention of CO2 may occur as respiratory function deteriorates. Monitoring changes in PaCO2 can provide insights into the patient's respiratory status and the effectiveness of ventilation.

The absence of breath sounds on auscultation on the affected side is a hallmark sign of tension pneumothorax because the accumulated air prevents normal lung expansion. As a result, the lung collapses, and breath sounds will be diminished or absent.

Notably, all these vital sign changes relate to the clinical picture of tension pneumothorax, making it appropriate to indicate