Your patient has been kicked in the chest by a horse and is having trouble breathing. Lung sounds are non existent on the right side where she was kicked and you believe she has a tension pneumothorax. During inhalation, her ______ ______________ impeding ventilation. When she exhales, her ________________ __________________.

a. blood pressure rises / blood pressure returns to normal

b. mediastinum moves left / mediastinum shifts, distorting the vena cava which results in poor venous return

c. lung on the affected side takes in air from the pleural space / lung passes that air back into the pleural space which increases intrathorasic pressure

d. ribs over the injured area move outward / ribs move inward over the non injured side

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