The priority for a client with a mandibular fracture whose teeth have been wired together is maintaining a patent airway. If the client begins to choke on oral secretions, the nurse should immediately attempt to clear the airway by suctioning via the oral or nasopharyngeal route. If this intervention is ineffective, cutting the wires may be necessary.
(Option 1) Cutting the wires can cause collapse of the fractured jaw and exacerbate the airway problem. This action is not the first priority unless the situation is an emergency (eg, acute respiratory distress, cardiopulmonary arrest requiring intubation). A wire cutter must be taped to the head of the client's bed at all times, including during travel.
(Option 2) Elevating the head of the bed is a preventive measure. Because the client is choking, the priority is suctioning secretions to clear the airway. The nurse should also turn the client to the side if the client has excessive oral secretions or begins to vomit to decrease the risk of aspiration.
(Option 3) The nurse should intervene to maintain the airway before calling the health care provider. A prescription for nasogastric suction to decompress the stomach may be indicated to reduce the risk of vomiting.
Educational objective: Maintaining a patent airway is the priority for clients with mandibular fractures who are unable to open their mouths. If choking occurs, the immediate intervention is to suction the mouth and oropharynx. If this is ineffective, cutting the wires may be necessary.
The priority for a client with a mandibular fracture whose teeth have been wired together is maintaining a patent airway. If the client begins to choke on oral secretions, the nurse should immediately attempt to clear the airway by suctioning via the oral or nasopharyngeal route. If this intervention is ineffective, cutting the wires may be necessary.
(Option 1) Cutting the wires can cause collapse of the fractured jaw and exacerbate the airway problem. This action is not the first priority unless the situation is an emergency (eg, acute respiratory distress, cardiopulmonary arrest requiring intubation). A wire cutter must be taped to the head of the client's bed at all times, including during travel.
(Option 2) Elevating the head of the bed is a preventive measure. Because the client is choking, the priority is suctioning secretions to clear the airway. The nurse should also turn the client to the side if the client has excessive oral secretions or begins to vomit to decrease the risk of aspiration.
(Option 3) The nurse should intervene to maintain the airway before calling the health care provider. A prescription for nasogastric suction to decompress the stomach may be indicated to reduce the risk of vomiting.
Educational objective: Maintaining a patent airway is the priority for clients with mandibular fractures who are unable to open their mouths. If choking occurs, the immediate intervention is to suction the mouth and oropharynx. If this is ineffective, cutting the wires may be necessary.
