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Victor Jones 81 y/o Male Primary Diagnosis: Right Femoral Neck…
Victor Jones
81 y/o
Male
Primary Diagnosis:
Right Femoral Neck Fracture
Pathophysiology
Open Reduction Internal Fixation: when multiple bones break, surgeon makes an incision to re-align the bone. The bones are held together by metal hardwares like screws or plates, even after the break has healed.
Possible complications
DVT r/t immobility, age and post-op
low oxygen saturation
difficulty breathing
cyanosis
CFT> 3 seconds
pain medication
leg elevation
heparin drip (adjusted by PT)
encourage mobility
Respiratory distress r/t oxygen levels and respiration rate
swelling in calf
extreme pain
redness
heat
administer oxygen
encourage mobility
encourage IS use
continuous O2 monitor
Treatment
General diet as tolerated
Vital signs every 4 hrs
Apply O2 PRN to maintain stats >92 %
IV Lactated Ringer 75 mL/hr
Foley to gravity
Take I/O q shift
Incentive Spirometer 10 x every 2 hrs
Dressing change q day before bed
Hip Precautions:
avoid bending hips >90 degrees
do not cross legs
do not twist leg in and out
place pillow between the legs
Full Code
Medications
Ancef 1 gm PO q 6hrs
Docusate Sodium 100 mg PO BID
PRN Medications
Morphine Sulfate 2-4 mg IVP PRN q 2 hrs for severe pain
Percocet 5/500 1-2 tabs PO PRN q 2 hrs (while awake)
Labs
CBC: monitor for bleeding (H&H, change in mental status, HR)
PT/PTT/INR: for heparin drip