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Create 3 nursing diagnosis with nursing interventions and expected outcomes using the case scenarios as guide....

Create 3 nursing diagnosis with nursing interventions and expected outcomes using the case scenarios as guide.

Mrs. A is an 82-year old female living alone, independent in her activities of daily living. She
has history of non-insulin dependent diabetes mellitus requiring insulin, hypothyroidism,
osteoarthritis, hypertension, ischemic heart disease, obesity and gastroesophageal reflux
disorder (GERD). Mrs. A recently suffered a hip fracture following a fall for which she
underwent a hip replacement surgery. Her post-operative course is complicated by a urinary
tract infection and two episodes of colitis. She was transferred to geriatric rehabilitation unit.
Patient height 160cm: weight 94kg (BMI=37kg/m2)

Solutions

Expert Solution

Hip replacement surgery: A surgical procedure in which the damaged or pain ful hip joint is replaced with prosthetic implants. It may be a total or hemi replacement surgery.  

Nursing Diagnosis: for Mrs.A

1. Impaired physical mobility related to surgery, pain and discomfort as evidenced by reluctance to attempt movement and reports of pain movement.

Expected outcome:

Client will display increased function and strength of affected joint and limb and participate in rehabilitation/ ADL programme.

Nursing Interventions:

* Maintain operated extremity in prescribed alignment and support the position with pillows.

* Turn on the unoperated side using an adequate number of personnel

* Administer analgesics before and after activities , to prevent muscle spasm andbpain

* Demonstrate and assist with transfer techniques and use of mobility aids such as Walker.

2. Risk for infection related to high glucose level and or Urinary tract infection

Expected outcome:

* Demonstrate lifestyle changes, techniques to prevent development of infection.

* Identify interventions to reduce or prevent risk of infection.

Nursing Interventions:

* Observe the surgical site for the signs of infection , and inflammation  such as fever , wound drainage, cloudy urine.

* Maintain strict aseptic techniques for all medical procedures for the patient such as site care, IV insertion etc.

* Hand hygiene have to maintain before and after the procedures .

* Administer antibiotics as per physician's order ; To prevent infection.

3. Imbalance nutritional status more than body requirements related to over intake of calories as evidenced by the BMI of 37 kg / m2

Expected outcome:

* Assist the patient in planning for designing the dietary modification to meet the patient's long term goal of weight control.

* Patient verbalizes the factors that contributing to weight gain / benefits of weight loss

* Patient achieves the desired weight loss in a reasonable period.

Nursing Interventions:

* Suggest the patient to keep a dairy for food intake and to check the adherence to the modified food plan.

* Assist in providing active exercises to the unaffected extremities and joints and passive exercises to the affected extremity.

* Provide / Have a low calorie heart healthy diet with moderte amount of protein.

Nightingale answered 2 years ago
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