Hip Arthroplasty Case Study
Concordia University, St. Paul
NUP 353: Nursing Role In The Acute Care Setting
Patient Profile
M.C. is a 64-yr-old white man who has had both hips replaced (left 6 years ago, right 2 years ago). He has a history of hypothyroidism. He was admitted to the ED after tripping over a short retaining wall in his backyard while gardening. He landed on his right side.
Subjective Data
Acute, severe pain in right hip, unable to bear weight on right leg
- Takes cholecalciferol (vitamin D3) 1000 IU every day without calcium supplement. States calcium upsets his stomach
Reports loss of about 30 lb in the last year through diet and exercise. Exercises 3 times a week
Lives in multilevel house with his wife. Bedrooms are on the second level
Has smoked /2 pack of cigarettes a day for the past 30 years
Describes himself as "a very light social drinker"
Objective Data
: 5 ft, 9 in tall, 175 lb
Diagnostic Studies
: X-rays show periprosthetic right proximal femur fracture at the greater trochanter with loss of fixation in the femoral part of the THA
- Normal CBC, chest x-ray
Serum calcium 8.1 mg/dL
Interprofessional Care
Revision of femoral part of his right total hip replacement with open reduction of the femoral fracture and fixation with 3 wires
IV hydromorphone (Dilaudid) 1 mg IV every 3 hr as needed
: Cefazolin 1 gram IV every 8 hr for 24 hr
Enoxaparin (Lovenox) 40 mg subcutaneous daily for 4 wk
- Calcium citrate 600 mg plus 800 IU vitamin D orally daily
- Levothyroxine (Synthroid) 125 mcg orally daily
PT for transfers, gait, and stair training
Occupational therapy for ADLs training
Discharge planning based on mobility limitations and need for continued PT and OT
Care Plan Instructions
Be sure to include all parts of the care plan process listed below in your final version.
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Assessment: Be sure to cluster your assessment data in an organized fashion. This should include only the assessment data pertinent to the top Nursing Diagnosis chosen.
64 year old patient. With increased age there will be a gradual decline in mobility, muscle
strength, bone density and joint health (Harding et al., 2020).
Serum calcium 8.1 mg/dL. Having low levels of calcium can lead muscle weakness,
spasms,
non-weight bearing on right leg
open reduction of femoral fracture and fixation with three wires
severe pain in right hip
Both hips were replaced, left hip 6 years ago and the right 2 years ago. This can cause
Acute severe plain in the right hip and unable to bear weight on the right leg.
Lives in a multi-level house with his wife and their bedrooms are on the second floor.
The patient smokes half a pack of cigarettes a day for the past 30 years.
PT/OT for transfers, gait, ADL, and stair training is needed to improve physical mobility
Diagnosis: Brainstorm at least three Nursing Diagnoses that would be good options for th