This paper will discuss the case of Mrs. Marble Harris, an 82 years old female, who was admitted into the hospital after being found by a nursing staff on the floor next to her bed. She was conscious and lucid and her right leg was generally swollen and extremely rotated to the left which could indicate hip fracture. She had an operation to fix the fracture. The past medical history revealed that she had taken an anti-inflammatory and analgesic tablets for osteoarthritis which affect her joint causing a lot of pain. This paper is going to discuss assessment tools, Mrs. Harris's main problems, nursing goals of management, nursing intervention and discharge planning.
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Client’s Health Problems
There are three top priority issues that Mrs. Harris suffers from:
First, Mrs. Harris is complaining of pain in her left leg and she has scored her pain level at 7 out of 10 and this indicates sever moderate to severe pain according to the pain scale. Recently, she had a fracture and a surgery has been done 16 hours ago and she is on analgesics which may not be enough to control the pain. On top of that, there is inflammation and pain on her left leg and these signs could be the early signs of deep vein thrombosis (DVT) which is a possible post-operative complication and it can be fatal (Salvo, Troxell & Duggan 2010). Pain can decrease the quality of the life and it has a direct and significant impact on the patient's life; moreover, too much pain can alter the neurological status of some patient resulting in serious complications (Brown 2014, pp.1429-1430).
Mrs. Harris' risk of impaired skin integrity is the second main health problem. It is a priority problem because skin breakdown can happen rapidly after the admission and she just had a big surgery and this will limit her ability to move so she may stay in bed for some time. According to (Chen, Chen & We 2010, pp.234-241) pressure ulcer is a common complication among patients who had surgery and they might develop it before, during or after the procedure due to immobility and friction. Moreover, her skin is fragile and prone to have injury from minor friction or tear which is normal age-related changes. Skin breakdown is a serious complication as it can expose patient to infection by increasing the chances of microorganism entering the body and that could increase the morbidity and mortality in elderly (Chow & Livesley 2007, pp. 1390-1396).
Mrs. Harris is at risk of impaired physical activity related to operation and age. Physical activity include performing activity daily living (ADL) and range of motion (ROM). Regaining mobility in Mrs. Harris is a big challenge for the care providers because of her age and the type of surgery as half all of older people with hip fracture will have difficulty in mobility and they will live dependently (Brown 2014, p.1395). In fact, Mrs. Harris' age is a significant factor which affect her mobility its effect was obvious as she was using a frame for walking before. Now, she had a major operation which usually need time to heal and restore function and her age may delay the process of healing.
Goals of Care
The first goal is controlling and reducing of Mrs. Harris' pain. Mrs. Harris will verbalize the relief of pain within the following few hours and the pain level will be controlled and managed appropriately. Thus, comfort and wellbeing will be promoted.
The second goal is to maintain skin integrity. Mrs. Harris' skin will remain intact and healthy and to ensure that Mrs. Harris is going to receive good care that can promote the skin condition. Moreover, identify any possibility of pressure ulcer development or...