You are caring for a patient in the ED who came in after a hard tackle in a football game. The x-rays show that he has a fracture of 2 ribs on the right side. Which intervention will the nurse expect for this patient?
Mechanical ventilation
Prepare for a chest tube
Needle decompression
Intercostal nerve block for pain management
The Correct Answer is D
Choice A reason:
Mechanical ventilation is not typically required for patients with rib fractures unless there is severe respiratory compromise or other underlying issues that necessitate ventilatory support.
Choice B reason:
Preparing for a chest tube is not generally required for isolated rib fractures unless there is an associated pneumothorax or hemothorax. Chest tubes are used to manage complications that involve air or blood in the pleural space.
Choice C reason:
Needle decompression is performed in emergencies to relieve tension pneumothorax. This procedure is not indicated for simple rib fractures without evidence of a tension pneumothorax.
Choice D reason:
An intercostal nerve block for pain management is an appropriate intervention for a patient with rib fractures. It helps control pain, allowing the patient to breathe deeply and cough effectively, which is important for preventing complications such as pneumonia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
A 72-year-old client with a brain tumor, GCS of 5, and decerebrate posturing may not be an ideal candidate for organ donation due to age and underlying cancer, which can affect organ viability.
Choice B reason:
A 24-year-old client after a motor vehicle accident with a GCS of 3 and no activity on electroencephalogram is a prime candidate for organ donation. The lack of brain activity indicates brain death, and the patient's young age and otherwise healthy organs make them suitable for transplantation.
Choice C reason:
A 68-year-old male with a massive stroke and GCS of 6 has significant neurological impairment but is not necessarily brain dead. Further evaluation would be required, but this patient may not meet the criteria for brain death necessary for organ donation.
Choice D reason:
A 50-year-old female with a GCS of 12 after surgical evacuation of an epidural hematoma is not an ideal candidate for organ donation at this time as they have a higher level of consciousness and potential for recovery.
Correct Answer is C
Explanation
Choice A reason:
Lower levels of arterial carbon dioxide do not directly facilitate brain oxygenation. While maintaining appropriate CO2 levels is important for overall respiratory function, the primary reason for targeting a specific PaCO2 range in traumatic brain injury is related to intracranial pressure control.
Choice B reason:
Although carbon dioxide is indeed a waste product that must be eliminated from the body, this statement does not explain why specific PaCO2 levels are targeted in the context of traumatic brain injury. The primary concern is the impact of CO2 on intracranial pressure.
Choice C reason:
Carbon dioxide is a potent vasodilator, and elevated levels can lead to increased intracranial pressure (ICP). By maintaining PaCO2 within a range of 35-38 mmHg, the healthcare provider aims to prevent hypercapnia and the resulting vasodilation, which can exacerbate intracranial hypertension in patients with traumatic brain injury.
Choice D reason:
Lower levels of arterial carbon dioxide are not specifically essential for gas exchange. The primary concern with PaCO2 management in traumatic brain injury is controlling intracranial pressure, rather than optimizing gas exchange alone.
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