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FNP Family Nurse Practitioner Exam Prep

Category - Women's Health Nurse Practitioner

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You are working at an urgent care. An elderly female patient has slipped on ice and is displaying classic symptoms of a fractured rib.

The patient’s GCS level is 15, and oxygen saturation on room air is 93%. Heart rate is 112, blood pressure is 142/102.

What is the most appropriate course of treatment for this patient?

  1. Use rib binders for comfort, apply high flow O2, transport to a trauma center
  2. Apply supplemental O2 via nasal cannula, monitor for ventilatory changes, transport to a trauma center
  3. Bind the ribs for comfort, apply nebulized albuterol for dyspnea, give 324mg aspirin for chest pain, transport to a trauma center
  4. Give nitroglycerine 0.4mg sublingual for chest pain, apply high flow O2, transport to a cardiac center
Explanation
Answer: B-The optimal treatment for patients with broken ribs includes supplemental O2 as needed and monitor for changes during transport to trauma center.

C-spine precautions should be considered per protocol. The use of chest binders is contraindicated as it can result in hypoventilation. This patient should receive an assessment for cardiac chest pain, but this etiology is unlikely given the mechanism of injury and nature of complaints.
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