How to Manage Hip Fractures
Hip fracture is one of the most common injuries that occur mainly among of older individuals. Evidently, it restricts the ability of the patients to move freely without the help of any other individual. Moreover, it also causes significant pain and disruption of life to frail patients, which is why it is imperative to handle them with extraordinary care. It is clearly evident that these patients need continuous attention and care from other individuals, which is why it is considered a very challenging area in the field of nursing.
After joining the profession of nursing, I soon came to realize that people with hip fracture are usually in the dire need of the caring nurses for their activities of daily living. For that reason, I spent significant time helping and aiding the patients that have hip fractures during my service. I remember one of my patients named John, whose upper femur was broken as the result of a fall in the bathroom. His doctor opted the Open Reduction Internal Fixation (ORIF) to repair the fracture with the help of plates, nails, screws, and pins. I provided an egg-crate mattress for this patient, keeping in view his particular condition and high pain levels.
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Egg-crate mattresses provided comfort and relieved John's bony prominences from great pressure. I also gave him a number of non-narcotic and narcotic analgesics such as ibuprofen, ketorolac, hydrocodone, and meperidine, to reduce his high pain levels. Moreover, I also made sure that his fractured area was immobilized all the time, with the help of abduction pillows. In addition, I also helped John in his ankle exercises to avoid any chances of deep vein thrombosis. I joined this particular area of nursing, after witnessing the intensive pain levels of patients with fractured hips and their inability to do anything on their own. It is also evident that most of the family members of these patients do not know the precautionary measures that need to be taken, in order to take care of the patient effectively. For that reason, I joined the profession of nursing, in order to help those patients who are unable to perform their daily life tasks because of their broken hip. I want to be the person to aid them at their weakest points in life. Moreover, I reviewed the article named ‘How to Manage Hip Fracture’, in order to increase my understanding of the methods necessary to care for patients with hip fractures.
I learned from this article that pneumatic compression stockings and anti-embolism stockings can also be used instead of ankle exercise. As the article stated, "anti-embolism stockings, pneumatic compression stockings, and anticoagulants will help prevent the deep vein thrombosis” (Pellino, 1994). Moreover, the article also discussed a lot of other helpful interventions to assist the patients with hip fractures, including assessing the patient's skin integrity and applying moisturizing lotions. In sum, this exercise has significantly increased my understanding about taking
effective.
I carried out this case study on Mrs. Casey (Pseudonym), any 86 year old woman who underwent an elective left total hip replacement (THR). After the OT student studied Mrs. Casey's past medical history in her medical chart, it was noted that she had previously undergone a right THR in 2011, which had been successful and free from complications. Ms. Casey had no other significant past medical history and had been an independent and active woman before the progression of her arthritis. Ms. Casey was required to have total hip replacements carried out on both hip joints as a result of severe Osteoarthritis (OA), which lead to stiffness, pain, and an eventual decrease in mobility, affecting her quality of life and involvement in meaningful occupations.
A 49 year old man who goes by the name of Martin was admitted into hospital with fractures in his left tibia and fibula and clavicle that he endured from a motor accident he was involved in. It is reported that there was a total of 146,322 personal injury road traffic accidents in the UK in 2014. (Department for Transport 2015). Surgery has been scheduled for Martin within the next day or two to fix the fractures he received in the accident; he is in a lot of pain. A fracture is to break a part, especially a bone (Weller, Pratt, and Barbara F 2014). Martin also mentioned that he has been feeling stressed recently from working a lot of overtime he is the bread winner in his home. In order to meet Martins health needs, provide person centered care and a range of services, a variety of professionals from the multidisciplinary team will be involved in his care delivery using a model of care (Roper-Logan-Tierney Model of Care 1996).
In this event, the matter that is unusual can be the fact that I have experienced and witnessed the process for interprofessional collaboration between the community nurse and other professionals that I have never knew about before. This event made me realize that there are many aspects of community nursing that I have knew about before where in this situation it is the importance and accountability of interprofessional collaboration. From my nursing theory course I have learned that interprofessional collaboration is when the nurse forms relationships with other professionals that enable them to achieve a common goal to deliver care and strengthen the health system and clients involved in it. (Betker & Bewich, 2012, p.30) In this event, our mutual goal is to provide the appropriate care for the patients/residents so they can restore their health after their hip or knee surgery. In the nursing leadership and management textbook it stated “interprofessional practice removes the gatekeeper and allows client access to all caregivers based on expertise needed.” (Kelly & Crawford, 2013, p.35) In this event, my preceptor and I gained knowledge about Revera and will pass on this information to patients who are interested in staying at a retirement home after they discharge from the hospital. One literature talked about how according to the Institute of Medicine, it is critical to have the capacity to work together as part of the interdisciplinary team to assist in delivering high quality, patient-centered care. In addition, effective collaboration among health care professionals results in improved patient care and outcomes. (Wellmon, Gilin, Knauss & Linn, 2012) This indicates the importance of interprofessional collaboration to provide...
Patients may present with pain in hip which is due to subarticular increased intravenous pressure in early stages of osteonecrosis marrow oedema, necrosis and also due to increased intracystic pressure associated with degenerative changes of hip in advanced stages of necrosis. In advanced stages, there may be collapse of femoral head, cheilus formation with adhesions around the periphery of femoral head and associated contracture of articular capsule which causes pain due to its stretching effect over t...
Falls can happen at any time and place in a hospital setting. It is a major patient safety issue causing injury, distress and even death. According to Debra Hain (2012), “In 2010, there were 2.35 million emergency room visits for non-fatal injuries in older adults with over 25% requiring hospitalization” (pg. 251). Falls can interrupt a person’s quality of life but also have a financial effect on the healthcare system (Hain, 2012). Falls are preventable and in order to reduce the rates for falls nurses must be more vigilant in their assessments to identify patients that are at risk, especially for those undergoing hemodialysis.
If patient safety is the most important issue in Health Care facilities then how come hospital inpatient falls continue to be the most reported of all accidental falls (Tzeng & Yin, 2009)? Throughout the years, hospitals continue to make changes to decrease the risk of accidents and increase the quality of patient safety. With research studies and improvements made, patient falls still hold the largest portion of reported incidents in hospitals (Tzeng, & Yin, 2008). According to Tzeng & Yin (2008), “fall prevention programs apparently do not effectively reduce inpatient fall rates because of human factors and ergonomics in a hospital environment (p.179, para. 2). The two studies reviewed in this paper were performed with the hopes of decreasing the high fall rate among inpatients.
...ches indicate how nurses can ensure prevention and mitigation of the problems experienced due to falls. There are various strategies that can be used to enhance the safety of individuals from falls. In order to be able to deal with these issues within the healthcare facilities, nurses must be involved in the effective policy making so that the risks of patient falling can be amicably dealt with. On the other hand, the nurses must be placed at the forefront of the implementation process of the designed interventions. Leaders must engage the nurses in applying the evidence-based therapies so that they can ensure good safety for the patients. Nurses are important in ensuring advocacy, education and the management of the facility environment. The nurses will therefore apply various necessary interventions that guarantee safe environments for the patients and the nurses.
Rush, K. L., Robey-Williams, C., Patton, L. M., Chamberlain, D., Bendyk, H., & Sparks, T. (2009). Patient falls: acute care nurses' experiences. Journal of Clinical Nursing, 18(3), 357-365. doi:10.1111/j.1365-2702.2007.02260.x
This Preusser (2008) case study involves a 75 year old female, S.P., who fell at home and is admitted to the orthopedic ward for an intracapsular fracture of the hip at the femoral neck (p. 183). Assessment data includes her height is 5’3”, weight is 118 lbs, blood pressure...
Nurses specialized in the care of orthopedic conditions may assist your physician in providing care. In addition, these nurses will help you to understand your treatment plan and can answer many of your questions.
Adding physical therapy in a nursing home setting can help not only with the mental and physical health of the residents, but also with the number of fall-related injuries that can occur. The addition of physical therapy can help slow down the effects of aging in the body and give the resident a less painful recovery. Many people believe that decreasing the amount of pain in a resident’s life will improve their mental health in the way that they will be able to enjoy life's simple activities to the fullest. Improving a resident’s mood will help avoid a sense of anger and confusion. Anger can increase frustration; which might lead the patient to attempt to stand, which results in a fall from lack of strength.
The nursing process is one of the most fundamental yet crucial aspects of the nursing profession. It guides patient care in a manner that creates an effective, safe, and health promoting process. The purpose and focus of this assessment paper is to detail the core aspects of the nursing process and creating nursing diagnoses for patients in a formal paper. The nursing process allows nurses to identify a patient’s health status, their current health problems, and also identify any potential health risks the patient may have. The nursing process is a broad assessment tool that can be applied to every patient but results in an individualized care plan tailored to the most important needs of the patient. The nurse can then implement this outcome oriented care plan and then evaluate and modify it to fit the patient’s progress (Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P., 2011). The nursing process prioritizes care, creates safety checks so that essential assessments are not missing, and creates an organized routine, allowing nurses to be both efficient and responsible.
Elderly are very prone for falling because of their age and health conditions. Nurses have to take appropriate steps for client’s safety and health. For example, taking vital signs and performing assessment after the injury for any changes in client’s level of consciousness. According to RNAO (Prevention of Falls and Fall Injuries in the Older Adult), nurses’ need to monitor and make frequent visits to clients’ room to prevent falls. Nurses should observe client’s behavior and needs to keep close observation on clients who are at high risk for fall. Especially the clients, who use walkers, nurses and staffs should remind them to use walkers at all time and tell them to call bell if they need anything. Make sure that clients wear eyeglasses if they have, wear proper shoes and their environment should be kept clutter free. Nurses can encourage clients to do stretches and exercises to strengthen leg muscle and take vitamin supplements if they need it. To decrease falls, always position the bed to the lowest height and non-slip mattress that is also
The role of the nurse in rehabilitation is extremely important . The rehabilitation nurse has to have certain skills to help patient into regaining her optimal level of function and to reintegrate back into society.
You identified several nursing diagnosis for the patient in question, I’d like to add that each of these diagnosis will require interventions with short and long term goals. For example, as you mentioned “The altered mental status would also impact this patient’s perception of danger and his own related to his hip fracture". Altered mental status is a common chief complaint among older patients, with this patient the altered mental condition is most likely age related. A short term goal example for this patient could be as follows: after two hours of nursing intervention, the patient will be calm and report improvement with his ability to cope with is confused state. Along term goal example could be that within 12 hours