The case study that has been provided for the purpose of this research paper is about Mrs Audrey Smith, a 75 year old woman who was brought to the Emergency department after she was found lying down on the kitchen floor by her neighbor. The patient had tripped over her dog and had been diagnosed with a fracture of the neck of the femur, soft tissue injurieries, bruising to her left shoulder and a small heamatoma on her left foirehead. The GSW scake reading is 14. The patient’s past medical history is indicative of AF, hypertension, L-CVA , T2dm GORD, osteopersosis, hysterectomy in the year 1995 and has been suffering from depression since the year 2011. The paper will analyze and critically acess the nursing interventions that are required for the patients safety, heath and hygiene. the patient is suffering from a fracture of the neck of the femur. It is a common injury that takes place in the elderly. Femoral neck fractures can either be extracapsular or intracapsular in nature. when the fcature is between the joint and the capsule it is known as an intracapsular fracture. These are very problematic as there is an interruption in the blood supply to the femoral head and can cause tissue necrosis. While the extracapsular fractures take place outside of the capsule. Here the blood supply is less compromised and operative fixation is mainly dependent upon the kind of fracture that has been caused.
The immediate nursing interventions that will be implemented when Audrey returns to the ward at 2000 hrs are as follows:
Post operative nursing considerations:
The patient could be at the risk of the following:
a. Alteration with respect to their ABC pathway, it comprises of hypertension and the patient has a past history of hypertension.
b. Urinary incontinence
d. Neurovascular deficit
e. Risk of infection
f. Unable to maintain hygiene
g. Deep vein thrombosis or PE
h. Problems in gaining mobility
i. Further or fractures that could occur in the future as the patient suffers from osteoporosis
j. Development of pressure ulcers.
l. Pain that is unresolved.
m. Nutritional deficit.
Also care needs to be taken that the patient is attended to at all times, pain medication is considered for pain management, usage of pressure relieving mattresses should be done so that pressure ulcers are not formed. The diet of the patient should be looked into so that the patient has optimum healing.
10 days after the surgery, Mrs. Audrey Smith will be sent to a rehab facility however prior to this transition it is imperative to ensure that the patient can adjust and adapt to the new changes that will be taking place in the times to come. Mentioned below are 4 nursing interventions that will be implemented during this transition phase for Audrey.
The paper has analyzed the care that needs to be provided to Mrs Audrey for a quick recovery. However nursing care is not just limited to surgery and the trauma that takes place it also addresses the deficits that are present in the patient’s health in the long run. Elderly patients are more prone to mal-nourishment and tend to have low hemoglobin. It is essential to monitor the dietary deficiencies so that proper wound healing can take place. Along with managing the strains that it causes to mobilization. The above mentioned interventions need to be followed for effective rehabilitation.
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