Question

Patient Introduction

Location: Orthopedic unit 1555

SBAR report from day shift nurse:

Situation: Mrs. Jacobson is an 85-year-old white female who was admitted last evening after falling and fracturing her hip. X-rays have been taken and show left intertrochanteric hip fracture. Mrs. Jacobson is scheduled for surgery tomorrow.

Background: Mrs. Jacobson has a 10-year history of osteoporosis, and her daughter reports that recently Mrs. Jacobson has been having dizzy spells.

Assessment: Mrs. Jacobson's vital signs are stable. Her pain is under control with morphine every 4 hours, and I medicated her at 1400. Her pain level was 2 after the morphine. The skin is intact; color and sensation around the hip area are within normal limits. A Morse Fall Scale assessment was completed on admission, and her score was 45. Fall precautions were implemented.

Recommendation: You will need to reposition Mrs. Jacobson as she needs to be turned every 2 hours. You should perform a focused musculoskeletal assessment, reinforce safety, and provide patient education on fall risk. Assess her pain level and medicate for pain if needed.

Fundamentals of Nursing Care

1. Taylor, C., Lynn, P., Bartlett, J. (2019). Fundamentals of Nursing: The Art and Science of Person-Centered Care, 9th Edition.

2. The Older Adult, Chapter 23, pp. 568-587
3. Assessing the Musculoskeletal System, Chapter 26, pp. 728-729
4. Components of a Neurovascular Assessment, Chapter 26, p. 721, Box 26-7
5. Preventing Falls, Chapter 27, pp. 772-773
6. Wound Healing, Chapter 32, pp. 1049-1050
7. Pressure Injuries, Chapter 32, pp. 1053-1056
8. Preventing Pressure Injuries, Chapter 32, p. 1069, Guidelines for Nursing Care 32-2
9. Ensuring Safe Patient Handling and Movement, Chapter 33, pp. 1152-1157
10. Positioning Patients in Bed, Chapter 33, pp. 1157-1158

Diseases and Conditions

1. Expert Clinical Content from Lippincott Advisor

2. Hip fracture Hip fracture
3. Osteoporosis Osteoporosis

Pharmacology

1. Expert Clinical Content from Lippincott Advisor

2. morphine sulfate-naltrexone hydrochloride morphine sulfate-naltrexone hydrochloride
3. raloxifene hydrochloride raloxifene hydrochloride

Procedures

1. Expert Clinical Content from Lippincott Procedures

2. Passive range of motion exercises Passive range of motion exercises
3. Antiembolism stocking application, knee-length Antiembolism stocking application, knee-length
4. Fall management Fall management
5. Fall prevention Fall prevention
6. Body mechanics Body mechanics

Assessment Tools

1. Hartford Institute for Geriatric Nursing, New York University College of Nursing

2. SPICES: An Overall Assessment Tool for Older Adults SPICES: An Overall Assessment Tool for Older Adults

question1 describe disease process affecting pation ( include pathophysilogy of disease process)

question 2 daignostic test ( reason for test and results)

q3- anaticipated physical findings

q4- anticipated nursing interventions

Answer 1