1.

Pain
- Hemiarthroplasty
surgical wound
- Pt reports aching,
persistent pain rated
8/10
- Analgesics (Tylenol,
PRN-Oxycodon,
Tramadol)

6. Relocation Stress
Syndrome
- Came from Samoa
-Hx Dementia
- Pt states very lonely
and wants to hurry and
go back home
- Cultural barriers
- Case Manager to
arrange post discharge
care

7. Impaired Gas
Exchange/tissue
perfusion

- Hx COPD
- Hx CAD w/ 3
intracoronary stent
placements
- 2L O2, nasal cannula
- O2 saturation 95%,
93%
- Low RBC=3.99,
Hgb=10.9, Hct=34.7
- Beta-blocker
(Atenolol)
- Anticholinergic, Beta2agonist
(Ipratropium/albuterol)

2. Impaired Mobility
- Moderate assistance
needed for bed
mobility/transfer
- Walker
- Fall risk precautions
- Hip precautions
- OT/PT treatment
- Anticoagulant (Heparin)

Chief Medical Diagnosis:

Right Femoral Neck Fracture/
Right Hip Hemiarthroplasty/
Post-op

3. Constipation
- No bowel movement
for 5 days prior to 1st
movement post-op
- When passing,
difficulty with hard
stool. Bright red blood
smear when wiping
noted
- Laxative/stool
softener
(Sennoside/Dulcosate
Sodium, PRNBisacodyl, MOM)

Priority Assessments: Pain,

focused CMS to right lower
extremity, gait

5. Impaired Skin
Integrity/Risk of infection
- Hemiarthroplasty surgical
wound
- Wound VAC
- MRSA +sputum
- Contact precautions

4. Deficient Knowledge
- New event (post-op)
- Hip precautions
- Unaware of new
medications
- Uncontrolled Diabetes
Mellitus type II
- Education/discharge
teaching

8. Impaired Home
Maintenance

- Hx Dementia
- Hx of fall
- Lack of support at
home
- Case Manager