Your patient, an unrestrained driver from a moderate-speed MVC, presents with abdominal tenderness and rib crepitus. Which organ injury should the nurse be concerned about?

In the context of a patient who is an unrestrained driver involved in a moderate-speed motor vehicle collision (MVC) and exhibits abdominal tenderness along with rib crepitus, the liver injury is of particular concern. The liver is located in the upper right quadrant of the abdomen and is susceptible to trauma due to its size and vascular nature.

Moderate-speed collisions can generate significant forces that result in abdominal injuries, especially to organs that are directly beneath the ribcage. Rib crepitus suggests a possible rib fracture, which can occur due to the impact of the seatbelt or the steering wheel. A fractured rib can potentially lacerate or compress the liver, leading to a liver injury such as a contusion or laceration, which could result in internal bleeding.

Additionally, while injuries to the spleen, kidneys, and pancreas are also possibilities in abdominal trauma, the presentation of abdominal tenderness alongside the mechanism of injury aligns predominantly with a concern for liver injury. The liver’s anatomical position and its vulnerability in MVC scenarios place it at higher risk for injury in cases involving upper abdominal trauma, particularly in the context of rib fractures.