Question

In: Nursing

Mrs. Lydia Martin, an 88-year-old widow, lives alone in her single-story home. She prides herself in...

Mrs. Lydia Martin, an 88-year-old widow, lives alone in her single-story home. She prides herself in being fully independent. During the middle of the night, Mrs. Martin fell in her home while walking to the bathroom. She was unable to get up, so she crawled to the telephone and dialed 911. She was transported to the emergency department and underwent diagnostic tests including hip and femur x-ray and computerized tomography (CT), which confirmed a left femoral neck hip fracture. Her past medical history reveals anxiety, osteoporosis, arthritis, and cataracts. Mrs. Martin underwent an open reduction internal fixation (ORIF) and a left hip replacement. Following surgery, she had a compression dressing with ice to the left hip, a Foley catheter, antiembolism stockings, a sequential compression device, a surgical drain and an order to use the incentive spirometer every hour while awake. Her medications included: Ampicillin 500 mg. IV q4hrs.; Morphine 1-2mg. IV q3-4 hrs. prn; hydrocodone bitartrate 7.5 mg/acetaminophen 750 mg (Vicodin ES) 2 tabs q4h po prn; and enoxaparin (Lovenox) 40 mg daily subcutaneously. On post-op day 1, the nurse and physical therapist began to work with Mrs. Martin; the goal of the session was to get her out of bed to a chair. During the attempted transfer, Mrs. Martin's surgical site was painful and her Foley catheter was pulled. She screamed in pain and refused to continue the process. Mrs. Martin was anxious and fearful of pain; she also became worried that she would never walk again and would end up in a nursing home. She was unwilling to move and declined physical therapy the next 3 days. Mrs. Martin became constipated and lost her appetite. She also developed a stage 2 pressure ulcer over her sacrum. Eventually, on post-op day 4 Mrs. Martin agreed to work with the physical therapist. By this time, she experienced significant weakness and fatigue and was unable to move independently. Mrs. Martin was later transferred to a rehabilitation center to continue regaining her mobility.

3. As the nurse, what other professionals would you collaborate with when caring for Mrs. Martin? Explain the importance of collaborating with the health care team when providing care for patients with hip fractures.

4. How would you apply principles of infection control when caring for a patient with a hip fracture?

5. Describe the nutritional needs of the patient with a healing fracture and the complications related to diet and medication use that could occur.

6. What interventions in the home would you assess to reduce the incidence of hip fractures?

7. You are planning to discharge Mrs. Martin. What community contacts and resources should you include in the teaching plan?

Expert Solution

1-Treating a patient is a team work it collaborate with different section of health care department.in this case patient need regular follow-up with physiotherapist as she unable to walk and weakness of muscle,also need support from infection control nurse to care her surgery site and proper dressing.

Physychiatrist to support her and reduce the anxiety as she has tested for this.reapiratory therapist because she have pron to get pneumonia as related to confined in bed.

Urologist visit may be needed for the catheter evaluation and follow-up.

Nutritionist to maintain a diet plan based on his needs.

Opthalmologist for follow-up for cataract

Also need lab and radiology team for sample analysis and to check progress of surgery.

As she stay alone she may need social worker support.

2-maintain an strict aseptic technique is important in all surgical case especially in hip surgery..Proper dressing and progress evaluation is needed.if fail to maintain strict infection control practice patient may have complications like wound infection,delayed wound healing and even sepsis and can cause shock and death.

3-for the progress of this includes development of bone and wound healing patient need to take adequate around of nutritional food that includes adequate akong of calcium vitamin d and c.it helps in wound healing and bone growth.

Also take adeqte aming of fluid since he is taking medication and bedridden.it improve skin turgor and preventburinary infection.

4-provide proper position

Assist in activities

Arrange articles near to bed

Remove any items that can cause injury

Keep side rails on

Keep bed lower

Transfer the patient with adequate resources

Maintain safety

Remove wet items while helping the patient to walk.

5-as she stays alone she need assistance from different section.so arrange a community nurse visit and contact number

Emergency hotline number arrange social worker and his contact

Domestic helpers agency number

Police and emergency contact details.

Nightingale answered 1 month ago

Mrs. Smith is an 88- year-old female who lives alone in her home. She walks with...

Mrs. Smith is an 88- year-old female who lives alone in her home. She walks with a walker. Last night Mrs. Smith needed to go to the bathroom. She got out of her bed and walked to the bathroom without using her walker. In the morning her daughter came to the house to check up on her. She found her mom on the bathroom floor. She called the ambulance and her mom was taken to the emergency room. In the...

Mrs. Brown is a 61 year old lady who lives at home with her husband. She...

Mrs. Brown is a 61 year old lady who lives at home with her husband. She has a history of hypertension that is controlled with medication. Mrs. Brown was walking through her home and tripped on the corner of one of her area rugs resulting in a fall with complaints of right hip pain. Her husband called an ambulance and Mrs. Brown was transferred to hospital. In the emergency department she was diagnosed with a minor pelvis fracture. She was...

Grace Markham is a 63-year-old widow who lives alone. She has a history of rheumatic heart...

Grace Markham is a 63-year-old widow who lives alone. She has a history of rheumatic heart disease manifested by moderate mitral valve stenosis with slight mitral insufficiency. She has been maintained on digoxin, 0.25 mg PO daily, for several years, with few adverse effects. Compliance with therapy has generally been excellent. She understands the drug therapy and her 3-g sodium diet. She was admitted to the hospital complaining of dyspnea on exertion, ankle edema, mild chest pain on exertion, and...

Case Study—The Client With Cardiovascular Disease Grace Markham is a 63-year-old widow who lives alone. She...

Case Study—The Client With Cardiovascular Disease Grace Markham is a 63-year-old widow who lives alone. She has a history of rheumatic heart disease manifested by moderate mitral valve stenosis with slight mitral insufficiency. She has been maintained on digoxin, 0.25 mg PO daily, for several years, with few adverse effects. Compliance with therapy has generally been excellent. She understands the drug therapy and her 3-g sodium diet. She was admitted to the hospital complaining of dyspnea on exertion, ankle edema,...

You are making a home visit to an 85-year-old woman who lives by herself. She has...

You are making a home visit to an 85-year-old woman who lives by herself. She has diabetes, is overweight, and has high blood pressure. She has just been discharged from the hospital where she was admitted for congestive heart failure. • What type of questions would be appropriate in making a physical assessment of the patient? • How would you learn about her activities prior to the hospitalization? • Why would this be important? • What observations would be critical...

Mrs. Fatima is 65 years old , celebrating her birthday . She is widow , lost...

Mrs. Fatima is 65 years old , celebrating her birthday . She is widow , lost her husband 6 month back . She lives alone but she has grandchildren who sometimes visit her She works as a school teacher . Everyone in the school was thanking her for her good work . Ali is a teacher working in the same school , he commented telling her that you are supposed to be at home by this age , you don't...

Christina is single with a 12 year old daughter who lives with her. She files her...

Christina is single with a 12 year old daughter who lives with her. She files her tax return as Head of Household. Her 2019 income from wages is $425,350. She has “net long-term capital gains” of $100,000. Total 2019 gross income is $525,350. She is under 65 years of age and does not itemize her deductions. What is her total federal income tax

Case Study 1: Mrs. Zaretsky (Health Illness and Disease) Mrs. Zaretsky a 64-year-old widow lives in...

Case Study 1: Mrs. Zaretsky (Health Illness and Disease) Mrs. Zaretsky a 64-year-old widow lives in a low-income area. She has multiple health problems including diabetes and hypertension. She eats a lot of fast food and smokes. She visits the clinic and community centre because of a sore on her foot that refuses to heal. She is on several medications but doesn’t always take them because she thinks they are too expensive so sometimes she doesn’t bother to get them...

Evelyn Kowalchuk, an 88 year old widow, and her son, Peter, put their savings into accounts...

Evelyn Kowalchuk, an 88 year old widow, and her son, Peter, put their savings into accounts managed by Matthew Stroup. Later, they initiated an arbitration proceeding before the National Association of Securities Dealers (NASD), asserting that Stroup fraudulently or negligently handled their accounts. They asked for an award of $832,000. After the hearing, but before a decision was rendered, Stroup offered to pay the Kowalchuks $285,000, and they e-mailed their acceptance. Stroup signed and faxed a settlement agreement to the...

Mrs. Smith is a 75 year old widow who is very active and healthy. She was...

Mrs. Smith is a 75 year old widow who is very active and healthy. She was brought in to the ED after collapsing at the grocery store. Mrs. Smith explains to the nurse practitioner she doesn't know what happened but she has been feeling exhausted and no energy for the last month. She tells the nurse practitioner, " I must be getting old, I am slowing down." The nurse practitioner is suspecting there is more going on than just age....