Question

You are working in the ED when M.C., an 82-year-old widow, arrives by ambulance. Because M.C. had not answered her phone since noon yesterday, her daughter went to her home to check on her. She found M.C. lying on the kitchen floor, incontinent of urine and stool and c/o pain in her right hip. Her daughter reports a PMH of hypertension, angina, and osteoporosis. M.C. takes propranolol (Inderal), NTG patch, and Premarin daily. The daughter also reports that her mother is normally very alert and lives independently. Upon examination, you see an elderly woman, approximately 100 lbs, 5’3”, holding her right thigh. You note shortening of the right leg with external rotation and a large amount of swelling at the proximal thigh and right hip. M.C. is oriented to person only, and she is confused about place, time, and event. M.C.’s VS are 90/65 – 120 – 24 – 36.4 C – 89% on RA. Preliminary Dx: right hip FX

1. In view of M.C.’s hx of HTN and the fact she has been without meds for at least 24 hours, explain the pathophysiology behind her current VS.

Answer 1

M.C is a 82 year old women with history of Hypertension, Angina and Osteoporosis

If this medicine is skipped , it leads to various side effects like abdominal pain, tenderness,bleeding, burning ,itching,confusion about identy, place and time,decreased awareness,dizziness, ligt headedness,mental changesetc.

Here she should have experienced its side effects and a fall and which lead to the fracture of Hip

The causative reasons are her weight,which all lead to the Situation