Fractured Ribs
- General information
- Most common chest injury resulting from blunt trauma
- Ribs 4-8 are most commonly fractured because they are least protected by chest muscles. Splintered or displaced fractured ribs may penetrate the pleura and lungs.
- Medical management: drug therapy consists of narcotics, intercostal nerve block (injection of intercostal nerves above and below the injury with an anesthetic agent) for pain relief
- Assessment findings
- Pain, especially on inspiration
- Point tenderness and bruising at injury site, splinting with shallow respirations, apprehensiveness
- Diagnostic tests
- Chest x-ray reveals area and degree of fracture
- pCO2 elevated; pO2 decreased (later)
- Nursing interventions
- Provide pain relief/control.
- Administer ordered narcotics and analgesics cautiously and monitor effects.
- Place client in semi- or high-Fowler's position to ease pain associated with breathing.
- Monitor client closely for complications.
- Assess for bloody sputum (indicative of lung penetration).
- Observe for signs and symptoms of pneumothorax or hemothorax.
Tuesday, May 20, 2008
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