A 93 Years old female was brought in by ambulance due mechanical fall.She fell while she was playing with her grandson.
Diagnosis: Ground level fall,left hip dislocation. History of hypertension, high cholesterol, heart burn.
Plan is pain control.
WBAT (Weight bearing as tolerated).
DVT Prophylaxis.
Up with physical therapist.
Dangle leg at bedside.
Left hip fixation with DHS.
Dressing to left hip intact.
PLAN:
SNF( Skilled Nursing Facility)
KEEP WOUND CLEAN AND DRY.
F/U with lab and further treatment.
Medications:
Hydrochlothyzide 25mg po in the morning at 09am Daily.
Lovenox 40mg subq Q24hours.
Coreg 6.5mg Bid.
Rocephin 1gm at 09am.
Pepcid 1tablet 09am Daily.
Ambien 1tab at bedtime.
Norco 325mg 1tablet Q4hours as needed for pain.
Tylenol 650mg po Q6hours prn.
Morphine 1mg Q4hrs break through pain prn.
Diet : Regular diet.
DAUGHTER VISIT :
The patient daughter came to visit before she is transferred to Skilled Nursing Facility.She looked at the dressing site and observed that it is oozing.She called and notify the nurse.The Nurse changed dressing immediately per doctor orders.Then the daughter asked what kind of metal did the doctor put in her mother’s hip?.What will be the nurse response to show that she understands.
(A) Your mother said that it is okay to tell you everything. The doctor placed a dynamic hip screw.Which is a type of Orthopedic implant designed to fix certain types of hip fractures.It will help her to heal better.
(B)I understand that your mom want me to tell you everything.But this is patient right. I am not supposed to discuss it with you.It is between the doctor and the patient.
The nurse chose the B answer. The daughter got mad and wanted to speak with the doctor, charge nurse and the manager. Is this a conflict or what?.
Nurses You Move Me 