MR is a 69-year-old African American retired nurse with a PMH of a hip fracture repair, a hysterectomy due to fibroids, CAD HTN and DM.
MR is a 69-year-old African American retired nurse with a PMH
Case Study Scenario:
MR is a 69-year-old African American retired nurse with a PMH of a hip fracture repair, a hysterectomy due to fibroids, CAD HTN and DM. Her daughter reports that her mother has become increasingly weak over the last two weeks and has been unable to complete her housework. (she has also been unable to attend the Mission meeting at the Baptist Church where she serves as a Deaconess.) Also, she has been developing swelling in her ankles and feet by late afternoon. She has also been experiencing nocturnal diuresis. Her daughter brought her in to her family physician who sent her to the ED because she has complained of heaviness in her chest and SOB off and on for the last two days. V/S: B/P 168/98; P 98; R 26; T 37.2C; SpO2 88% on RA.
Older patients presenting with hip fractures are some of the frailest and sickest patients in hospital. In addition to complex medical problems and comorbidities. They have to overcome the additional physiological challenges posed by the hip fracture itself, and subsequent surgery. Hip fracture associated morbidity and mortality at one year remains high. Published guidelines stress the need for a multidisciplinary approach and the importance of the care environment for good outcomes. A combined management approach identifies and addresses not only the surgical but also the complex analgesic, medical, cognitive, nutritional, social and rehabilitation needs of our patients, thereby improving outcome for our patients.
Hip fracture, multidisciplinary, occupational therapy, orthogeriatrician, patient centred care, physiotherapy