question archive Jeanine Porter is a 75-year-old woman who was admitted to the hospital after she fell at home and sustained an intracapsular fracture of the left hip at the femoral neck
Jeanine Porter is a 75-year-old woman who was admitted to the hospital after she fell at home and sustained an intracapsular fracture of the left hip at the femoral neck
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Jeanine Porter is a 75-year-old woman who was admitted to the hospital after she fell at home and sustained an intracapsular fracture of the left hip at the femoral neck. She is widowed and lives with her daughter and son-in-law and their three children, ages 15, 12, and 4. She has a 50 pack-a-year smoking history and denies alcohol use. She has severe osteoarthritis of her knees and coronary artery disease (CAD). She underwent coronary artery bypass grafting (CABG) 9 months ago. Since her surgery, she has engaged in minimal exercises at home. Mrs. Porter underwent a total hip replacement. Her postoperative period was unremarkable, and she was transferred to the rehabilitation facility on her third postoperative day. She did well with her therapy and was discharged home after 10 days.
Nursing Assessment
At a home health visit 2 weeks after discharge, Mrs. Porter was in the living room, seated in a rocking chair. Her walker was across the room. The room smelled of smoke, and a significant amount of dust was evident on all of the furniture, as well as open bags of chips and several open soft drink cans. The floor was littered with toy trains and cars, and the sofa was full of unfolded, clean laundry. In the kitchen, the countertops and sink were loaded with dirty dishes, pots, and pans. Mrs. Porter said, "My daughter is really doing her best. I guess I am just too much for her...what with the children and all." Mrs. Porter's daughter replied, "I can handle it, I just don't get any help from anyone, including my mother."
what is 3 diagnosis on this patient?
what can be patient outcome on this diagnosis with time frame?
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1. Ineffective tissue perfusion. Patient should engage in minimal-moderate movement exercise at least 5 minutes everyday.
2. Risk for Impaired skin integrity r/t ineffective tissue perfusion. Patient should be free from signs of ulcerations in at least 2 weeks time.
3. Ineffective family coping. Patient as well as significant others should learn healthy coping mechanisms in handling the family in 2 weeks.
All plans will be evaluated in the next home health visit. I used the ABC method of prioritization based on her problem. Although, she is smoking, it should have been a problem regarding airway or breathing but there was no assessment indicating problem to those area.
