Question

provide a care plan for elderly patient that has been admitted with a medical diagnosis of fractured hip and second day post op for hip arthroplasty

-Provide a care plan for patient with first ten days post op after amputation

-provide a care plan for an inpatient who is on traction

-Provide a care plan for a patient in a cast ; Day 1-28

Answer 1

Care plan of patient with hip fracture:-

-advise patient of benefits of post-opt exercises to increase mobilization.

-The patient will be free from any DVTs if treatment and prevention done appropriately.

-The patient should told of how to correctly use the trochanter roll to help hip alignment.

-The patient should advised how to properly change positions to relieve pressure with a little pain possible.

-The patient should advised how to properly use trapeze bar when transferring in bed.

-The nurse educate and provide the patient with reading material on hip surgery.

-The nurse will asssess the patient questions and concerns about her hip surgery.

-The nurse and physical therapy will educate and demonstrate to the patient post-opt exercises to increase mobilization.

-The nurse will ensure patient wears compression stockings and SCD device daily to decrease DVT development.

-The nurse will educate the patient how to correctly how to use the trochanter roll to help hip alignment.

-The nurse will educate the patient how to properly change positions to relieve pressure with a little pain possible.

-The nurse will educate the patient how to properly use trapeze bar when transferring in bed.

Care plan for patient with amputation:-

1). Impaired physical activity:-

- encourage patient to perform prescribed exercises.

- provide stump care on daily basis.

- measure circumference periodically.

2). Risk of infection:-

- monitor vital signs

- wrap the amputed leg in normal saline

- administer prophylactic antibiotics

3). Risk for ineffective tissue perfusion:-

- perform periodically neuromuscular assessment

- insect dressing and drainage device

4). Situational low self esteem:-

- Help the amputee cope with his altered body image.

- Encourage expression of fears, negative feelings, and grief over the loss of body part.

- Reinforce preoperative information including type and location of amputation, type of prosthetic fitting if appropriate (immediate, delayed), expected postoperative course, including pain control and rehabilitation.

Care for patient who is on traction:-

-Position a rolled up towel/pillow under the heel to relieve potential pressure.

-Encourage the patient to reposition themselves or complete pressure area care four hourly.

-Remove the foam stirrup and bandage once per shift, to relieve potential pressure and observe condition patients skin.

-Keep the sheets dry.

care for a patient in a cast:-

• Elevate the affected area. For the first 24 to 72 hours after cast is applied, use pillows to raise the cast above the level of heart. Patient will need to recline if the cast is on a leg.
• Apply ice. Loosely wrap an ice pack covered in a thin towel around your child's cast at the level of the injury. Wrapping the ice is important to keep the cast dry. Ice that's packed in a rigid container and touches the cast at only one point won't be as effective.
• Keep moving. Encourage patient to frequently move the fingers or toes of the injured limb.
• Avoid dirt. Keep dirt, sand, and powder away from the inside of your splint or cast.
• Padding. Do not pull out the padding from your splint or cast.
• Itching. Do not stick objects such as coat hangers inside the splint or cast to scratch itching skin. Do not apply powders or deodorants to itching skin. If itching persists, contact your doctor. If something gets stuck inside your cast it may irritate your skin, so contact your doctor.
• Trimming. Do not break off rough edges of the cast or trim the cast before asking your doctor.
• Skin. Inspect the skin around the cast. If your skin becomes red or raw around the cast, contact your doctor.
• Inspect the cast regularly. If it becomes cracked or develops soft spots, contact your doctor's office.