Professional Documents
Culture Documents
arried
Room #: 223
Chief complaint: Vehicular accident
Provisional diagnosis: Acute Traumatic hip dislocation R 2° to
vehicular accident
Attending physician: Dr. Montano
The client has good relationship with his wife. They
have been married almost for 7 years and currently
living in together. Even though the client is married,
he still doesn·t lose contact with his family. As for him
-
The client recreation activity was to watch TV
with his wife this serves as their bonding time
together. At times when he is tired from
work, his wife would give him a massage
and also to relive his stress.
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The client resides in a studio type house. They
lived in a compund where there is less noise
surrounding their house. According to the
client, ´
but the client perceives it as a
tolerable condition and not a problem.
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practices like taking a
bath
ADL Before During Interpretation
Hospitilization Hospitalization and Analysis
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During the degenerative process the cartilage that lines the hip joint,
called hyaline cartilage, is damaged. The damage results from the
abnormal forces on the cartilage from the deformed hip socket.
Small fractures can occur in the cartilage also. Eventually an
enzyme is released that degrades the joint further and decrease the
synthesis of an important joint protectant called proteoglycans. The
cartilage becomes thinner and stiffer, further compromising its ability
to handle the stresses of daily movement and weight bearing.As the
problem progresses more enzymes are released, which now affect
the precursors to proteoglycans, molecules called
glycosaminoglycans and hyaluronate. Lubrication is negligible,
inflammation occurs, and the joint fluid can no longer nourish the
hyaline cartilage. This viscious cycle continues until pain occurs. The
body attempts to reduce this pain by stabilizing the hip joint. New
bone is deposited at the joint, both inside and out, along with some
of the ligaments and muscle attachments to the area. This causes
thickening and a decrease in the range of motion. This is the actual
arthritis noted on a radiograph, which will not go away and will
continue to progress.
V Hypothesis ² factors like physical, mechanical, nutritional, predispose the
normal physical functioning of the host but mechanical factor of agent
lowers the resistance and impairs physical mobility.
V
V Predisposing
o Host
V Male patient is 37y/o, he was born in the Philippines; He is a pure Filipino living
with his wife in Laguna. The pt. has a high level of self-esteem and
confidence. For his nutritional status He stated that he balances his food
intake, when he ate in a fast-food chain he sees to it that later that day he
essentially consume veggies or fruit, while he consumes small amount of
water. When it comes to the customs and tradition, they dominantly follow
the beliefs of Jehovah·s Witness but haven·t been baptized to the religion. To
both sides of his parents, there were no reported health problems. The
patient had a complete immunization and recently had a diarrhea and
fever. During the interview, the pt. felt puzzled and looked depressed when
his wife told him that he would be acquainted with an artificial hip joint to be
applied in his right hip in order for him to resume to his normal life. He had a
fringe benefit provided by the company he was working which pays for the
emergency health situation or accident. After the operation, he was not
able to move a lot and consumption of food intake lessened.
V
o Agent
V The patient undergone surgical operations
specifically close Reduction in the right hip
applying 3kg metal bag. After the operation,
the patient felt no pain and responds to
questions actively.
o Environment
V Assessing the environment, there was a
sufficient lightning in the room and garbage
was segregated and the room temperature
was warm.
E
A H
V Analysis
Host and agent increases the alteration in normal
functioning that makes them more powerful than the
environment thus causing impaired physical
immobility.
V Conclusion
Precipitating cause is predominantly impaired
physical immobility and greatly influenced by
secondary factors which was the application of 3kg
metal bag in his right leg.
V Recommendation
General health of the patient should be considered
Consume nutritious meals and normal fluid intake
(Healthy and balanced diet)
Minimize to extraneous movement
Maintaining dressing clean, dry and intact until fully
healed.
Oursing Problems Cues Justification
Identified
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Oursing Problems Cues Justification
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Oursing Problems Cues Justification
Identified
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*8 This problem should be
2
also be solved
because it is also it will
create more serious
disease if it is not taken
18 seriously.
2 *
ased on client·s
priority, the client thinks
that sleep is something
important.
Resources are also
available to the family,
and the nurse
Cues Health Problem Analysis Goals and Nursing Rationale Evaluation
Objectives Interventions
Impaired Impaired
*8 Goal: after
· mobility related mobility
2
Limitations
nursing
"
to hip
dislocation as independent, intervention
manifested by purposeful s, the client
physical
difficulty of will be able
movement of
> moving. the body or of
to maintain
2 ·2" one or more or increase
extremities. strength
" and
The client had
>
a vehicular function of
accident that affected
damages his and or
right hip
causing hip
compensat
dislocation. ory body.
The client is at
risk of having
fractures due
to changes to
age.
18 Fractures occur Objectives:
when the bone
2
is subjected to The client will
'" stress greater be able to:
that it can
absorb. When Verbalize
the bone is understanding
"" broken, of situation and
adjacent individual
" structures are treatment
also affected, regimen and
" resulting in soft safety
2
tissue edema, measures.
hemorrhage Demonstrate
into the muscles techniques or
and joints, joints behaviors that
dislocations, enable
ruptured ten- resumption of
" dons, severed activities.
nerves, and Participate in
damaged ADLs and
blood vessels. desired activity
ody organs Maintain
maybe injured position of
by the force function and
that caused the skin integrity as
fracture evidenced by
fragments. After absence of
a fracture, the contractures
extremities foot drop,
cannot function decubitus, and
properly so forth.
because
normal
functions of
muscle depend
on the integrity
of the bones
K
Reinforce the importance of taking medication regimen
for continuity of care and prevention of the
reoccurrence of the disease.
Encourage the patient to take the medication
compliance.
=
Tell the patient that she may have to decrease his
activities and may not be allowed to do any hard
exercises.
Advise patient to comply medications as prescribed by
the physician.
Advise patient to increase fluid intake to avoid dehydration
Advice the patient to follow balance diet, to check
P and his pulse rate
and ask someone to check her respiratory rate daily, and to have
adequate rest and sleep.
Teach the patient different ways to relieve strain and prevent further trauma
to joints
Cane or walker when indicated
Posture and body mechanics, avoid excessive weight bearing and
continuous standing
Educate the patient regular physical activities, strengthening exercises-
help keep or increase muscle strength, aerobic conditioning
exercises- improve cardiovascular fitness, help control weight, and
improve overall function. Range-of-motion exercises- help reduce
stiffness and maintain or increase proper joint movement and flexibility.
Instruct the patient to consult first the physician or physical therapist to
learn which exercises are appropriate and how to do them correctly,
because doing the wrong exercise