A 68years old female is brought in by family member s/p right hip replacement in June of 2021.History of hypertension, chf. Full code,standard precautions. High risk for fall,yellow gown,yellow armband,fall yellow sticker at the door,bedside commode , patient placed close to the nursing station.No advance Directive.Copy of advance Directive in front of the chart.02 at 2liter nasal canula with saturation of 96%.Skin integrity is impaired redness and bruises to right hip.No known allergy. Regular diet ,npo after midnight. Right total hip revision done this morning. Dressing to the right hip intact,patient is able to wriggle her toes. SCD on the left leg.Foley catheter in place.
0.9NS infusing at 75ml/hr via pump to left forearm saline lock 20guage.IV site intact/ clean/patent. Vancomycin 1gm IV ×1 given.Zosyn 3.378gm IV Q8hours.
Dilaudid 1ml IV Q3hours prn pain.Norco 10/325mg 1tablet po Q6hours prn moderate pain.Tylenol 650mg po for temperature Q4hours prn.Morphine sulfate 4mg IV Q4hours prn severe pain.
Norvasc 10mg po Qdaily at 09am scheduled. Lovenox 40mg SubQ Q24hours daily scheduled.
Vital signs Q4hours and prn.
Patient will be discharged home in two days with family if medically stable. Follow up in two weeks with Orthopedic surgery department and in three weeks with primary care physician.
1.What is total hip replacement?.Why is there a revision of the hip replacement?.Think about it and consult your textbooks and online.
2.What are the fall risk prevention protocol?.
3.Why is this patient a fall risk ?.
4a.What is SCD?.
4b.Why does the patient have SCD to the left leg?.