Question

Case study 3. Activity and exercise case study: Mrs. Gomez

Mrs. Gomez underwent surgery 2 days ago for repair of a fractured hip she suffered in a fall. She has an incision over her left hip area that is free of redness with well-approximated edges. She experiences pain upon movement even though she is being adequately medicated for pain. The Physician has ordered daily physical therapy and that Mrs. Gomez be ambulated three times daily. Mrs. Gomez does not want to get out of bed because she does not want to experience another fall.

Why is it essential to maintain proper body alignment when turning Mrs. Gomez or helping her out of bed to ambulate?

What assessment findings would alert you that Mrs. Gomez is developing problems associated with her current state of decreased mobility?

Cite examples of exercises you can recommend for Mrs. Gomez that will reduce her risk for disuse syndrome during her recovery.

What are some of the factors you should consider prior to moving Mrs. Gomez to a sitting position on the edge of the bed in preparation for ambulation?

Answer 1

Proper body alignment essential when turning mrs.gomez because to prevent blood pooling,to stimulate circulation and to relieve pressure on tissues..The patient should be placed in unnatural postions because it may damage joints and muscle groups..so considerations should be taken not to damage muscle groups by moving both legs simultaneously..it helps them to avoid dislocation hip,DVT,negative bed-rest outcome,blood clot,pneumonia,delirium..
    After the initial 24hours monitor vitalsigns every 8hours..monitor incision site and dressing should be done..monitor drainage amount and signs of infection..patient should sit up in a chair at the bedsite and ambulating with assistance by this time..But mrs.gomez not ready for mobilization due to her chronic pain and anxiety that she may fall again..
   Disuse syndrome caused by bedrest after hip fracture,vertebral fracture etc..After 3weeks ambulation must be permitted due to disuse-associated decreased in muscular endurance and general endurance..with chronic pain and anxiety exercise will help to get recovery..encourage active range of motion exercise helps keep muscle in current strenght and promote circulation..explain exercise and rationale to client that helps them choices that appeal..provide step-by-step motor activity during exercise it help them to remainder to recall what to do next..Deep breathing exercise can be performed with incentive spirometry..collaborate with physical,occupational and recreational therapist to develop tailored exercise program..
Hip precautions are must to prevent dislocation of hip when it is heal,to prevent drainage to be in place..some factors like hip dislocation,chronic pain and muscle damage to be consider to moving a patient to a sitting position on the edge of the bed..when the moving patient to sit and bring them to a edge of the bed..operated leg should be moved first with lot of support..then other leg..foot rest to be placed when patient sitting in the edge..support is must to prevent dislocation,fall,and displacement of drainage..provide walker to the patient for the support..