Question

N342- Adult Health 1

Older Adult With Fractured Hip

Patient Profile
M.S. is an 85-year-old woman who fell in the bathroom when getting out of the shower and broke her left hip. She is now three days postoperative following an open reduction and internal fixation (ORIF) by posterior approach of her left hip. Before the surgery, she was healthy and was able to take care of herself and independently meet all of her activities of daily living.

Subjective Data

· Lives alone in a two-story house

· Does not drive

· Has a friend in the community who takes her to church, doctor, and hair appointments, and who does her grocery shopping for her on the weekends

· Has one son who lives two hours away

· Only insurance of record is Medicare

Objective Data

Physical Examination

· Alert and oriented to person and place; occasionally disoriented to time and situation

· Wound is clean, dry; dressing is intact

· Otherwise physical assessment is unremarkable

Diagnostic Studies

· Laboratory values all within normal limits

Collaborative Care

· Requires moderate assistance with transfers (per physical therapist)

· Requires moderate assistance with ADLs (per occupational therapist)

· Takes hydrocodone with acetaminophen (Vicodin) by mouth every 6 hours as needed for pain control

1) What physical limitations will be placed on M.S. during her recovery that will affect her discharge needs?

2) Considering these limitations, what support systems would be necessary for her to return home or go to her son’s home?

3) It is decided that M.S. will be discharged to a long-term care facility for rehabilitation. Her son asks how long she will be there. In answering his question, what information might you give him regarding her long-term health outcome?