Hello Can you please help me with the next question? (The main concept is pain) Helen Mellum is a 78-year-old female who suffered a right fractured hip after falling on the ice. She had a right hip pinning done and has just arrived on the orthopedic floor from the recovery room where she received a dose of hydromorphone (Dilaudid) IV two hour ago. Orders include Dilaudid 1mg every 2 hours prn. She has a history of chronic obstructive pulmonary disease (COPD) and hypertension (HTN). Vital signs: BP 114/62, HR 72, RR 16, temp 37.2, O2 saturation 96%. She is drowsy, but arouses easily. Lung sounds are clear. When sleeping breathes with her mouth open. Heart tones are distant but regular. Feet are cool to touch bilaterally with pedal pulses at 2+. Capillary refill at 1 second. Skin turgor elastic, tongue is dry. Right hip incisional dressing is dry and intact. She complains of constant, sharp incisional pain, rated at 7 on scale of 0-10. She indicates the intensity goes up to a 10 when she moves. She has an IV of normal saline infusing at 50 ml/hr and she is on a clear liquid diet. The assignment is: Analysis (Analyzing Cues) Which client conditions are consistent with the cues? Do the cues support a particular client condition? What cues are a cause for concern? What other information would help to establish the significance of a cue? The cues I have by now are: elevant Client Information: - Age: 78 years old - Medical history: COPD and hypertension (HTN) - Surgery and current condition: Right hip pinning post-fracture, with recent administration of IV hydromorphone (Dilaudid) - Vital signs: BP 114/62, HR 72, RR 16, temp 37.2, O2 saturation 96% - On physical examination, the patient is drowsy but rousable; their heart sounds are clear and regular; their feet are chilly and have adequate pedal pulses; their tongue is dry; and the dressing over their hip incision is intact. - Pain assessment: Constant, sharp incisional pain rated at 7/10, increasing to 10/10 with movement Most Important Client Data: - Vital signs: Indicating stable blood pressure, heart rate, respiratory rate, temperature, and oxygen saturation. - Pain assessment: Emphasizing intense discomfort around the incision, which is worsened as you move around. - Surgical site assessment: Dry and intact dressing, which is crucial for assessing wound healing and potential complications. Immediate concerns are related to: - Managing pain: dealing with the intense incisional pain, which is rated at 7 out of 10, and it gets worse as you move. It may be necessary to reevaluate her condition and possibly change her pain medication regimen if the present dosage of Dilaudid is not effectively alleviating her symptoms. - Respiratory status: taking into account her history of chronic obstructive pulmonary disease (COPD) and symptoms, such as sleeping with her mouth open and a dry tongue as indicators. Possible respiratory impairment or dehydration, which could impact pain management and recovery, could be indicated by these indications. Thank you in advance!
Hello
Can you please help me with the next question? (The main concept is pain)
Helen Mellum is a 78-year-old female who suffered a right fractured hip after falling on the ice. She had a right hip pinning done and has just arrived on the orthopedic floor from the recovery room where she received a dose of hydromorphone (Dilaudid) IV two hour ago. Orders include Dilaudid 1mg every 2 hours prn. She has a history of chronic obstructive pulmonary disease (COPD) and hypertension (HTN). Vital signs: BP 114/62, HR 72, RR 16, temp 37.2, O2 saturation 96%. She is drowsy, but arouses easily. Lung sounds are clear. When sleeping breathes with her mouth open. Heart tones are distant but regular. Feet are cool to touch bilaterally with pedal pulses at 2+. Capillary refill at 1 second. Skin turgor elastic, tongue is dry. Right hip incisional dressing is dry and intact. She complains of constant, sharp incisional pain, rated at 7 on scale of 0-10. She indicates the intensity goes up to a 10 when she moves. She has an IV of normal saline infusing at 50 ml/hr and she is on a clear liquid diet.
The assignment is:
Analysis (Analyzing Cues)
Which client conditions are consistent with the cues? Do the cues support a particular client condition? What cues are a cause for concern? What other information would help to establish the significance of a cue?
The cues I have by now are:
elevant Client Information:
- Age: 78 years old
- Medical history: COPD and hypertension (HTN)
- Surgery and current condition: Right hip pinning post-fracture, with recent administration of IV hydromorphone (Dilaudid)
- Vital signs: BP 114/62, HR 72, RR 16, temp 37.2, O2 saturation 96%
- On physical examination, the patient is drowsy but rousable; their heart sounds are clear and regular; their feet are chilly and have adequate pedal pulses; their tongue is dry; and the dressing over their hip incision is intact.
- Pain assessment: Constant, sharp incisional pain rated at 7/10, increasing to 10/10 with movement
Most Important Client Data:
- Vital signs: Indicating stable blood pressure, heart rate, respiratory rate, temperature, and oxygen saturation.
- Pain assessment: Emphasizing intense discomfort around the incision, which is worsened as you move around.
- Surgical site assessment: Dry and intact dressing, which is crucial for assessing wound healing and potential complications.
Immediate concerns are related to:
- Managing pain: dealing with the intense incisional pain, which is rated at 7 out of 10, and it gets worse as you move. It may be necessary to reevaluate her condition and possibly change her pain medication regimen if the present dosage of Dilaudid is not effectively alleviating her symptoms.
- Respiratory status: taking into account her history of chronic obstructive pulmonary disease (COPD) and symptoms, such as sleeping with her mouth open and a dry tongue as indicators. Possible respiratory impairment or dehydration, which could impact pain management and recovery, could be indicated by these indications.
Thank you in advance!
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