Question

The nurse is assessing a client admitted with injuries sustained in a motor vehicle accident. Which of the following injuries poses the greatest risk to the client? A. Fractures of the ribs B. Contusions of the lower legs C. Fractures of the humerus D. Lacerations of the face

Short answer

A. Fractures of the ribs B. Contusions of the lower legs C. Fractures of the humerus D. Lacerations of the face Answer: A. Fractures of the ribs

Step-by-step solution

Analyze the injuries and their potential complications

Each option presents a different type of injury. We need to consider the possible consequences and severity of these injuries for the client. - Fractures of the ribs (option A) can lead to difficulty breathing, lung puncture, or internal organ damage. - Contusions of the lower legs (option B) can result in bruising, swelling, or pain, and might limit mobility, but usually does not pose life-threatening risks. - Fractures of the humerus (option C) can cause pain, limited mobility and nervous or vascular injury. However, it doesn't usually impose serious or life-threatening risks. - Lacerations of the face (option D) may lead to blood loss, infection or scarring, but usually don't pose significant risks for the patient.

Compare the injuries and their potential implications

Considering the analysis in step 1, we can observe that some injuries pose greater risks than others: - Fractures of the ribs (option A) can lead to complications that might be life-threatening if not treated correctly, such as a lung puncture or organ damage. - Contusions of the lower legs (option B), fractures of the humerus (option C) and lacerations of the face (option D) mostly cause pain, limit mobility, and might result in some level of disability or discomfort, but generally don't pose life-threatening risks for the patient compared to option A.

Select the injury that poses the greatest risk to the client

Based on the comparisons made in step 2, we can conclude that fractures of the ribs (option A) pose the greatest risk to the client as they can lead to life-threatening complications. The other injuries, although still requiring proper care, are generally not as severe or critical as this type of injury. So, the correct answer is: A. Fractures of the ribs

Key concepts

Nursing Assessment

The nursing assessment is the cornerstone of patient care, especially in emergency situations like those seen in the aftermath of a motor vehicle accident. This process involves gathering comprehensive information about the patient’s condition. Nurses begin by collecting data through physical examinations and patient history.
Once initial observations are made, nurses categorize injuries based on severity and potential risks.

• Vital signs such as blood pressure, heart rate, and respiratory rate are monitored continuously to detect any immediate complications.
• Observation of physical and emotional reactions, including pain levels and patient anxiety, provides insights into hidden injuries.

This structured approach ensures that each injury or condition is identified and addressed appropriately, allowing for swift interventions that prioritize patient safety.

Injury Evaluation

Injury evaluation is a critical part of nursing care, especially following traumatic events. It involves a detailed analysis of each injury to determine its potential impact on the patient's health. For instance, when assessing injuries from a car accident:

• Rib fractures might pose severe risks due to potential complications like lung punctures.
• While contusions and humerus fractures can be painful, they often do not carry the same life-threatening implications.
• Lacerations, though potentially cosmetically concerning, need prompt attention to prevent infection.

Injury evaluation helps prioritize the type and urgency of medical intervention needed for each injury, ensuring the most critical issues are treated immediately.

Patient Safety

Patient safety is the main priority when dealing with injuries from a car accident. Ensuring safety involves assessing the environment and interventions to prevent further harm. Nurses play a key role in monitoring patients for potential deterioration.
Patients with rib fractures, for example, require close observation for signs of respiratory distress, a potential threat to their health. Furthermore:

• Protect the patient from movements that might aggravate their injuries.
• Implement protocols to prevent infection from open wounds such as lacerations.
• Facilitate a calm environment to help alleviate patient anxiety, which can exacerbate injury symptoms.

These proactive measures are essential to uphold patient safety and ensure a comprehensive recovery process.

Clinical Decision-Making

Clinical decision-making in nursing involves evaluating and choosing the best course of action based on patient needs and medical knowledge. In scenarios involving multiple injuries, such as a car accident victim, the process becomes complex yet vital.

• Nurses must determine which injury carries the greatest risk to allocate resources effectively.
• This involves balancing immediate life-threatening issues with other potentially disabling injuries.
• Decisions are based on evidence-based practices, clinical expertise, and patient preferences.

For instance, prioritizing rib fractures over other injuries involves assessing their potential complications and determining the rate of deterioration if not treated quickly. Such decisions support optimal patient outcomes and efficient use of healthcare resources.