What are the priority nursing interventions at this time

Reference no: EM133272461

Assignment:

Patient Profile

D.R. is a 74-year-old obese Hispanic woman who is in the 3rd postoperative day following an open reduction internal fixation (ORIF), for repair of a left femoral neck fracture after a fall at home.

Subjective Data

States pain in her left hip is 4-5/10
States pain in her left calf area is 3/10

Objective Data

Physical Examination

Vital signs: BP 140/68, HR 64, temp 98.7°F, RR 20

Oxygen saturation 93% on room air

Lungs clear all lobes

Bowel sounds are present in all 4 quadrants

Apical pulse: 64 & irregular

Alert & oriented to person, place, & time

Skin warm to touch bilateral lower extremities, slight erythema left lower

extremity

No edema right lower extremity, 2+ left lower extremity

Pedal pulses 3+ right lower extremity, 1+ left lower extremity

Calf circumference: right 8cm, left 10cm

Left hip wound has staples, no signs or symptoms of infection

Last bowel movement was 4 days ago

Interprofessional Care

Medication Administration Record

Morphine sulfate 2 mg IVP every 2 hours as needed for pain 6-10/10

Lisinopril 20 mg PO daily

Bisacodyl 10 mg PO daily

Discussion Questions

What do you suspect is occurring with D.R.? What data were used to make this determination?
What are the priority nursing interventions at this time?
Using SBAR, what would you report to the provider?
What diagnostic studies would be used to determine the existence, location, and extent of the (answer to question 1)?
What risk factors for development of (the answer to question 1) does D.R. have?
What measures can be taken to prevent the (answer to question 1) in an at-risk patient?
What treatment do you anticipate for D.R. after she has been confirmed to have a (answer to question 1) in her left lower extremity?
What is the most serious complication of a (answer to question 1) and how would you monitor D.R. for this complication?

Reference no: EM133272461

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