What assessment finding would you expect during one respiratory cycle in a client who has a paralyzed left phrenic nerve?
A. Left side of the diaphragm would fail to rise during inhalation and would be un-affected during exhalation.
B. Left side of the diaphragm would fail to rise during exhalation and would be un-affected during inhalation.
C. Left side of the diaphragm would fail to flatten during inhalation and would be unaffected during exhalation.
D. Left side of the diaphragm would fail to flatten during exhalation and would be unaffected during inhalation.
C
The diaphragm is the major muscle of inhalation and is controlled by the phrenic nerve. In its relaxed state, during exhalation, the diaphragm resembles an inverted bowl and presses high against the thorax. Contraction of the diaphragm occurs during inhalation, causing the muscle to flatten, resulting in enlargement of the thoracic cavity. Paralysis of the left phrenic nerve would make the left side of the diaphragm remain in a relaxed state, even during inhalation. Thus, inha-lation would be less effective but exhalation would be unaffected.
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