Medical Surgical Flail chest & Rib fracture #2

Question

The nurse is going over discharge instructions with a client who has a rib fracture. Which statement by the client indicates additional teaching is indicated?

Answers

  1. “I will hold a pillow against my rib when I am doing my breathing and coughing exercises.”
    • Rationale:

      This answer is not correct since it is an effective intervention against an ineffective breathing pattern. Splinting with a pillow while practicing coughing and deep breathing will also help with the pain.

  2. “ I will take my pain medication as prescribed.”
    • Rationale:

      This answer is not correct because taking pain medication as prescribed is an appropriate intervention. Keeping pain relieved aids the client in breathing appropriately.

  3. “I will contact my provider if I experience shortness of breath.”
    • Rationale:

      This answer is not correct since shortness of breath can be a negative sign with a client who is recovering from a rib fracture. Contacting the provider for shortness of breath, acute pain, fever or cough is important for the client who is recovering from a rib fracture.

  4. “I will rest in bed daily until I fully heal.”
    • Rationale:

      This answer is correct because by the client not returning to their normal everyday activities, they are at risk for pneumonia. Staying sedentary puts the client at risk for other serious issues too, such as deep vein thrombosis. It is important to stay active and not to rest in bed all day. The provider will talk with the client about the type of work and activities that will be allowed.

Overview

It is important for a client with a rib fracture to stay active. Becoming inactive can cause lung collapse or an infection. Staying in bed with rib fractures do not allow the lungs to fully expand.

Explanation

Learning Outcomes

For the client with a rib fracture, it is important to stay active and not rest in bed all day. The provider will talk with the client about the type of work and activities that will be allowed. The client who does not return to their normal everyday activities are at risk for pneumonia. Staying sedentary puts the client at risk for other serious issues too, such as deep vein thrombosis. Splinting with a pillow while practicing coughing and deep breathing will help decrease the pain associated with those exercises. By taking pain medications as prescribed, the client will be encouraged to breath appropriately. Contacting the provider for shortness of breath is indicated since this could be a sign of a complication.

Test Taking Tip

Know that the client with rib fractures will have a nursing diagnosis of Acute Pain and Ineffective Breathing Pattern. These both can result in bigger problems if not addressed.

Video Rationale