Social History J.B. grew up in rural West Virginia on a small tobacco farm with no running water. They grew their own food, drew their water from a well, and made their own clothes. She left home at the age of 18 and married her first husband. The marriage was not successful, and seven years later they divorced. J.B. remarried and she and her husband became involved in a conservative Baptist church in southern Ohio. They raised three children, while he worked in a metal alloys factory and she operated the church’s daycare center. They both retired early and followed two of their children when they moved out of the area. After moving, her husband had several hospitalizations due to cardiac issues, and since they weren’t old enough to qualify for Medicare, they collected a great number of medical bills. Instead of claiming bankruptcy, they foreclosed on their house, moved to one of their son’s rentals, and …show more content…
has intermittent pain and weakness in her right knee, she is at risk of falling. To address this concern, an appropriate nursing diagnosis is the risk of falls related to altered mobility from pain and weakness. Subjective data related to the risk of falling are the self-report of seasonal dizziness and intermittent increases in pain and weakness. The objective data that support this diagnosis are her age, unsteady gait and difficulty rising from the chair and low toilet. The desired outcome for J.B. is that she will be free from falls while under my care. Interventions for J.B. include instructing her about the effect of exercise on the progression of osteoarthritis, obtaining a physical therapy order for strengthening exercises, collaborating with her primary care physician to develop a pain medication regimen for times when her pain increases, using cold therapy on her knee during flare-ups, exchanging her non-slip bath strips in the bathtub for a non-slip bath mat, and installing a raised toilet seat (Durham, Fowler, & Edlund,
Click here to unlock this and over one million essaysShow More
Introduction Have you ever been a situation whereby an elderly patient with high fall risk was left alone in a toilet? Elderly tend to be more fragile and are prone to serious injuries when they fall. (Hill & Fauerbach, n.d.). In hospital wards, nurses do the best measurements to ensure zero falls, maintain a clean record and raise awareness to prevent falls. Description It was an incident that happened during one of my clinical placement in September.
Discussion Post Week Eleven NURS6551, N-6 As an advanced practice nurse (APN), one will evaluate many patients with musculoskeletal and endocrine conditions. Therefore, the clinician must be aware of subtle differences that occur in various diseases to ensure proper diagnosis and treatment. For the purpose of this week’s discussion, I will choose a case study and explain the likely diagnosis along with the differentials.
(Wilson et al. 2016) Individualizing and specifying fall preventive interventions and strategies for different type of patients based on their fall risk factors are more likely to reduce falls than general interventions used such as signs on their doors (Wilson et al., 2016). The purpose of this study was to examine the perception of nurses regarding the use of fall prevention interventions specific to patients at risk for falls and to implement the use of these fall prevention strategies used to promote these fall prevention practices (Wilson et al., 2016). The fall risk factors in the mobility risk category included gait instability, bilateral lower extremity weakness, assistance needed to get out of bed and/ or walk, and the use of mobility equipment. Some fall prevention interventions used to address these risk factors included ambulation three to four times per day with or without assistance unless contraindicated; referral to physical therapy for assessment, gait, and/or strength training; range of motion; minimizing use of immobilizing equipment and/or assist with ambulation; and use of proper assistive equipment (Wilson et al., 2016).
Problem Identification Getting out of bed is one of the dangerous things that the elderly patients do when they are admitted in the hospital. Study conducted by Ambrose, Paul & Hausdorff, (2013) on patient falls reveals that a majority of falls in the elderly patients occur between 0700 and 1900, especially when they are getting out of bed to use the rest room. The cause of their falls is mainly due to unsteady gait, memory loss, confusion that comes with age. Memory loss and vision problems which occurs during old age in the elderly patients puts them at risk for falls. Other factors that can lead to falls are; Presence of throw rugs, psychotropic medications, lack of Vitamin D, and weakness of the lower extremities.
As working as a Certified Nursing Assistant in a long term care rehabilitation facility, I encounter many elderly patients who are admitted for fall related injuries. The majority of patients are recovering from total knee and hip replacements as a result from falling at home or elsewhere. Fuller states, “Falls are the leading cause of injury related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years…More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons of over 70 years of age” (Fuller, 2000, para.1). There are many factors that can contribute to the reason why individuals, particularly the elderly,
The clinical practice guidelines that were selected for this paper are from the National Guideline Clearinghouse and from International journal of nursing studies. The Hendrich Fall Risk Model was primarily developed as a predictive nursing assessment tool based on epidemiological research (NGC, 2011). The Guidelines were developed by the Hartford Institute for Geriatric Nursing the committee was however not stated. Authors were asked to sign confidentiality documents and all the authors agreed this. The research was conducted by hand searches of public literature and searches of electronic database.
Mrs Jones physical shows she had a hip operation thereby causing her pain, reducing her mobility and access to her occupation and engagement. Additionally she has difficulty in weight bearing on her right leg due to her operation and experiencing muscle weakness causing her limited endurance and strength when walking and transferring. Cognition: It was documented the patient experienced post-operative confusion, memory loss, difficulty following and understanding post hip surgery caution. Affective (mood): Patient experienced low mood and lacks confidence walking due to her illness, this has impacted on her emotion.
It also provided the use of critical thinking and clinical judgment on how to prevent falls, support, and be accountable for a client professionally. The practical knowledge I have learned helped me become aware of assessing and assisting a client. As a nurse, our job is to provide “safe, compassionate, competent and ethical care” (p.8) and collaborate as an interprofessional team to deliver safe care and prevent risks from happening while offering quality nursing care (CNA, 2017). I will always provide the professional care under the code of ethics to promote health and wellness for an older adult and prevent risks from happening. As well as following the plan of care, use communication strategies, be aware, acknowledge, and accommodate individuals with different diseases such as with dementia, to promote fall prevention strategies (RNAO, 2017).
The nurses should conduct fall risk assessment during the admission and post procedure. The patients who are the high risk, a red identification will be place on the patient’s limbs. A red sticker also is placed at the nursing notes and at patient room door. If the patient is not a high risk patient, the fall assessment is done weekly or upon change in patient condition. Not forgetting pediatric patients, it is a must to nurse patient who are below then three years old in a baby cot.
Because of the severity of the fall, the physician indicated that after surgery and stabilization, your relative will require physical and occupational therapy. After three weeks of rehabilitation, you are informed that your loved one has been unable to reach their baseline. You are requested to consider permanent placement in a long term care bed in the same facility. discuss the following in terms of a " facility" in your area:cost, impact of insurance type, care plan , the admission process, state and county laws that govern the
Utilizing fall risk scores does not apply only to the older population but to patients of all ages. Implementing this change into my nursing practice will help me identify those at risk and apply the appropriate interventions, such as a bed alarm, for the patients who are unsteady on their feet or are trying to ambulate by themselves. Moreover, I will continue to treat the elderly population with respect. All of us can learn a great deal of information about these patients and other various subjects if we not only make time for these patients but also
An incident report is initiated by the nurse after care has been delivered to the fallen patient; fall incident is evaluated, staff are educated and policies reviewed. The incident report is reviewed by the unit manager and forwarded on to fall risk management for deliberation at the next gathering. The goal of the fall committee is to come up with structured and individualize preventive measures and possible revision of
5 NURSING PROCESS The nursing process is a series of organized steps designed for nurses to provide excellent care. Learn the five phases, including assessing, diagnosing, planning, implementing, and evaluating. 5:1 Personnel Context As a nurse can make a huge difference in the health of my patients by many methods.