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Chapter: Medical Surgical Nursing: Management of Patients With Musculoskeletal Trauma

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Rib - Fracture

Uncomplicated fractures of the ribs occur frequently in adults and usually result in no impairment of function.

RIB

Uncomplicated fractures of the ribs occur frequently in adults and usually result in no impairment of function. Because these frac-tures produce painful respiration, the patient tends to decrease respiratory excursions and refrains from coughing. As a result, tra-cheobronchial secretions are not mobilized, aeration of the lung is diminished, and a predisposition to pneumonia and atelectasis re-sults. To help the patient cough and take deep breaths, the nurse may splint the chest with her hands. Occasionally, the physician administers intercostal nerve blocks to relieve pain and to permit productive coughing.

 

Chest strapping to immobilize the rib fracture is notused, be-cause decreased chest expansion may result in pneumonia and at-electasis. The pain associated with rib fracture diminishes significantly in 3 or 4 days, and the fracture heals within 6 weeks. In addition to pneumonia and atelectasis, complications may in-clude a flail chest, pneumothorax, and hemothorax.


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