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Dx: Left hip fracture

Summary :

 is an 85-year-old white female with a history of osteoporosis. She lives at home by herself where she fell and broke her left hip yesterday evening, after having complaints of dizziness, weakness, and fatigue. She is scheduled to have surgery in 2 days.

Medications:

· Enoxaparin sodium 40 mg SQ daily

· Docusate sodium 100 mg PO daily

· Morphine sulfate 4 mg IV q4h prn for pain

· Metoprolol 25 mg PO BID

· Furosemide 20mg PO daily

Orders:

· Vital signs every 4 hours

· Activity: Bed rest

· Anti-embolism stockings on both legs (knee-length)

report

S: Mrs. Jacobson is an 85-year-old white female who was admitted last evening after falling and fracturing her hip. X-rays have been taken and show left intertrochanteric hip fracture. Mrs. Jacobson is scheduled for surgery in 2 days.

B: Mrs. Jacobson has a 10-year history of osteoporosis and was newly diagnosed with congestive heart failure last year. Her daughter reports that recently Mrs. Jacobson has been having dizzy spells, fatigue, and weakness. Mrs. Jacobson lives alone and is usually able to perform all her ADLs independently. She does have a cane at home but often times refuses to use it because she “doesn’t think she needs it”. Mrs. Jacobson is usually pretty active, but has been much more sedentary lately due to increasing weakness and fatigue due to medication non-compliance with her heart failure medications.

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R: You will need to reposition Mrs. Jacobson as she needs to be turned every 2 hours. You should perform a focused musculoskeletal assessment, reinforce safety, and provide patient education on fall risk. Assess her pain level and medicate for pain if needed.


Student
 Date 
Instructor Course 
Patient Initial Unit/ Room# DOB 
Code Status Height/Weight 
Allergies 
Temp  (C/F Site)Pulse  (Site)RespirationPulse Ox (O2 Sat)Blood PressurePain Scale 1-10
      
History of Present Illness including Admission Diagnosis & Chief Complaint (normal & abnormal) supported with Evidence Based CitationsPhysical Assessment Findings including presenting signs and symptoms supported with Evidence Based Citations
History of Present Illness & Chief Complaint: Admission Diagnosis: Admitting dx: Left intertrochanteric hip fracture, pain  Explain what a left hip fracture is                                    GENERAL: HEENT: CHEST: HEART: LUNGS: ABDOMEN: PELVIS:. UPPER EXTS: LOWER EXTS NEUROLOGIC: SKIN:
Relevant Diagnostic Procedures/Results & Pertinent Lab tests/ Values (with normal ranges), include dates and rationales supported with Evidence Based Citations  Past Medical & Surgical History, Pathophysiology of medical diagnoses (include dates, if not found state so) Supported with Evidence Based Citations
Diagnostic testing: abnormal Left hip xray   Labs: Hematology: Hb 14, HCT 42, Platelets 195, WBC 8, RBC 4.3 -all within normal range Electrolytes: K+ 3.8, Na 142, Creatnine 0.8, Cl- 101, BUN 20, HCO3- 24, Calcium total 8.6 -all within normal range    Past Medical (Pathophysiology of medical diagnoses): Surgical History:   Medical hx: Diagnosed with osteoporosis 10 years ago in 2011   Explain pathopysiolgy of osteoporosis  
Erikson’s Developmental Stage with Rationale And supported by Evidence Based CitationsSocioeconomic/Cultural/Spiritual Orientation & Psychosocial Considerations/Concerns (3) supported with Evidence Based Citations
   Religion: Christian Social background: White, female, English speaker, widowed, mother of 1 daughter, lives with daughter –               Concerns: -depression – need of assistance at home –
Potential Health Deviations, Predisposing & Related Factors; (At least two) Include three independent nursing interventions for each  (“At Risk for…” nursing dx)Inter-professional Consults,  Discharge Referrals, & Current Orders (include diet, test, and treatments) with Rationale supported with Evidence Based Citations
At risk for: loss of physical function – perform active range of motion 2 a day – – Rick for skin integrity   Consults/ discharge referrals: Orthopedic consult, physical therapy, social worker  Orders: take pain medication prn Diet: n/a
Contributing Factors
Diagnostic Label
   Related to
       As evidenced by
Signs and Symptoms

Priority Nursing Diagnosis (at least 2) Written in three part statement  
Planning (outcome/goal) Measureable goal during your shift (at least 1 per Nursing diagnosis)  Prioritized Independent and collaborative nursing interventions;  include further assessment, intervention and teaching (at least 4 per goal)Rationale Each must be supported with Evidence Based CitationsEvaluation Goal Met, Partially Met,  or Not Met & Explanation  
impaired physical mobility related to ROM 1. 2. 3. 4.1. 2. 3. 4. 
     
Risk for pressure ulcer    
     
     
     
     
     

MEDICATION LIST

Medications (with APA citationsClass/PurposeRouteFrequencyDose (& range) If out of range, why?Mechanism of action Onset of actionCommon side effectsNursing considerations specific to this patient
Enoxaparin sodiumAnticoagulants  subcutaneousdaily40   
Docusate sodiumLaxatives, Stool Softener  oraldaily100   
MorphinOpiate, narcoticIVPRN every 4 hrs4   
        
        

Topic


In a democratic nation, people vote for policy changes and government officials. On many occasions, new policies regard the environment, health, and education; additionally, politicians campaign using these policies as supportive or weakening arguments to be elected or re-elected.

Questions

1. Most people are not scientifically literate; should they still be allowed to vote? Explain your answer.

2. What measures would you consider ethical and moral, if any, to ensure that the voting public is educated to cast their votes based on the correct interpretation of factual data instead of the influence of fake news? Explain the rationale for your proposed measures. 

3. Ask an open-ended question to your classmates on the topic of this discussion or a closely related topic.

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Instructions

You have been hired as a high school nutritionist and your first big task is to carry out a “Healthy Lifestyles” nutrition campaign. You want the students you work with to understand the relationship between the four categories of biological macromolecules and the food they eat.

Prepare a brochure or flyer that clearly and accurately educates your students about lipids, carbohydrates, proteins, and nucleic acids. Your flyer should include the following information about each type of macromolecule:

  • structural makeup
  • overall function in the body
  • types of food where each biomolecule can be found

Your flyer should also include an overall theme that emphasizes the importance of a healthy diet.

Take a look at the hints in this worked example for help completing this assessment.

Basic Requirements (the assignment will not be accepted or assessed unless the follow criteria have been met):

  • Assignment has been proofread and does not contain any major spelling or grammatical errors
  • Assignment includes appropriate references
  • Assignment includes a food source for each biomolecule illustrated.
  • Assignment emphasizes an overall healthy diet.