Musculoskeletal Disorders--Linh Tran
Destiny Josling, Emily Stephenson, Emily Carson, Kayla Rawlings, Sydney Warren
Linh Tran
76 years old
History of osteoarthritis(10 years) and osteoporosis, hypertension
2 children who visit often, she sees her 2 grandkids 3 times a week
Medications
Naproxen once daily for arthritis
Questions
Does she take medication for her hypertension?
Alendronate for osteoporosis
Chief Concern
Hospital Medications
Morphine
Put on antibiotics
Enoxaparin
Warfarin--Held due to INR of 5
Vitamin K
advised to use acetaminophen for pain
Fall at home, brought in by ambulance
X-ray confirms Right Hip fracture
Findings of palor and absence of pedal pulse in right foot
Compartment syndrome---Taken to OR to repair RT hip fracture
Recovery
Good canadiate for Rehab
Post-Op
Rehab for 3 weeks before being discharged
2 days in ICU following complaints of chest pain and SOB
Antiembolic stockings
Discharge
Home care nurse completes a needs assessment for adaptive equipment
Discharge instructions are given
Follow-up appointments made
When stockings are removed the nurse notes that the right leg is red, warm, and edematous and immediately places Linh on bedrest.
Questions
Why did the symptoms of blood clot or DVT occur considering she was on a blood thinner?
Why was she put on antibiotics?
Did she have a follow-up blood culture for her INR?
Was she taking any calcium or vitamin D supplements while she was on alendronate?
Lives in an apartment building for older adults
Joint pain in the right knee worsening
Widowed female
Did the joint pain in her right knee worsen her fall?