The nurse is working in the ED when an 92-year-old widow, Ruby Skinner,arrives by ambulance. Her ni

The nurse is working in the ED when an 92-year-old widow, Ruby Skinner,arrives by ambulance. Her niece Peggy accompanies her.  Mrs. Skinner is disoriented so the nurse takes a history from her niece.  Because Mrs. Skinner had not answered her phone since noon yesterday, Peggy went to her home to check on her.  Peggy found her aunt lying on the kitchen floor, incontinent of urine and stool, with complaints of pain in her right hip.  Peggy reports that Mrs Skinner has a past medical history of hypertension, coronary artery disease with coronary artery stent placement (9 months ago), GERD, and osteoporosis.  Peggy states that her aunt takes metoprolol, nitroglycerin patch, furosemide, omeprazole, and estrogen daily.  Mrs. Skinner smoked for most of her adult life, but quit recently after her stent placement.   Peggy reports that Mrs. Skinner is normally very alert and lives independently.On examination the nurse finds an elderly Caucasian woman holding her right thigh. The nurse notes shortening of the right leg with external rotation and a large amount of swelling at the proximal thigh and right hip.  Mrs. Skinner is oriented to person only and is confused about place and time. Her vital signs are 90/65, 120, 24, 97.5° F; her SaO2 is 89% on room air. She is profoundly dehydrated.  Mrs. Skinner is approximately 5 feet 3 inches tall and weighs about 100 pounds.  X-rays confirm the diagnosis of right hip fracture.Based on her history and physical exam, what risk factors for a hip fracture does Mrs. Skinner have?  -In planning further care for this client, list two potential life threatening complications (emergency situations) for which Mrs Skinner should be monitored and describe why they might occur? -One serious post operative complication is bleeding.  Other than blood on the dressing, list three assessment parameters the nurse would monitor for excessive postoperative blood loss? -Another serious post operative complication is infection.  Other than purulent drainage, list three assessment parameters the nurse would monitor for joint or wound infection.  Remember that Mrs. Skinner is 92 years old so individualize the assessments? -By observing “hip precautions,” what post operative complication is the health care team trying to prevent? Health Science Science Nursing NURSE 224 Share QuestionEmailCopy link Comments (0)

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