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Med Surg Simulation Admission Ticket - Agnes Taylor...

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Amanda Pitts Session: Scenarios: Fun 2:

NUR201 Hip Fracture/Postoperative Bleed Agnes Taylor – Hip Fracture/Postoperative Bleed

1. Describe the pathophysiology and discuss some of the common risk factors for osteoarthritis.  OA involves the gradual loss of articular cartilage with formation of bony overgrowths (spurs or osteophytes) at the joint margins. OA is not a normal part of the aging process, but aging is one common risk factor for disease development. Decreased estrogen at menopause may contribute to the increased incidence of OA in aging women. Obesity is a modifiable risk factor that contributes to hip and knee OA because it increases mechanical stress on the joints. Anterior cruciate ligament injuries from quick stops or pivoting are linked to increased risk for knee OA. Work that requires frequent kneeling or stooping also increases the risk for knee OA.

2. What are some factors that contribute to the occurrence of falls and hip fractures in older adults?  Loose rugs, uneven or slippery surfaces, postural imbalance, decreased strength, decreased reflexes, decreased senses.

3. What are the early signs and symptoms of postoperative bleeding requiring assessment?  Decreased blood pressure, increased heart rate, excessive blood in drain, excessive blood on wound dressing.

4. Discuss what the abductor splint/pillow is for and the relevance it has to the management of the patient who has undergone repair of a hip fracture.  Available in standard or adjustable models, hip abductor splints maintain alignment of the hips postoperatively. Abductor splints and pillows are used to alleviate pain caused by poor alignment in patients who have undergone hip fracture repair surgery.

5. What priority nursing interventions should be implemented for the management of this patient?  Oxygen therapy (incentive spirometer, and coughing/deep breathing). Administer medications as prescribed. Continue to monitor for signs and symptoms of postoperative bleeding....