Which assessment finding would the nurse expect to document for a client with an open pneumothorax?

A. Sucking sound on inspiration and expiration: An open pneumothorax occurs when air enters the pleural space through a chest wall defect, creating a direct communication with the atmosphere. The hallmark “sucking” or hissing sound results from air moving in and out of the pleural space with each breath. This allows loss of negative intrapleural pressure, leading to lung collapse on the affected side. B. Tracheal deviation towards the side of injury: Tracheal deviation toward the affected side is typically seen in lung collapse from conditions like atelectasis, not in open pneumothorax. In open pneumothorax, the air can escape through the chest wall, preventing the tension necessary to push the trachea toward the lesion. C. Symmetrical chest movement: Chest wall movement is usually asymmetrical in an open pneumothorax. The affected side demonstrates reduced expansion due to lung collapse, and air may audibly move through the open wound, making symmetrical chest rise unlikely. D. Tracheal deviation away from the side of injury: Tracheal deviation away from the injury occurs in tension pneumothorax when air accumulates in the pleural space without escape. In an open pneumothorax, air escapes through the defect, so tracheal deviation is generally not present unless tension develops.