Question

You are a nurse preparing to receive a new patient, fresh from surgery, to your unit. The patient is a 71-year-old man who underwent a surgical repair of a fractured femur. As you receive a report from the postanesthesia recovery unit, you learn that his medical history includes hypertension, 40 pack-years of smoking, and CPD. His surgical repair was successful but complicated by excessive bleeding, and he is receiving IV fluids to compensate. He is widowed, and his three children are scattered throughout the United States. He lives alone, receives Meals on Wheels, and pays a cleaning service to keep his home clean. (Learning Objectives 3, 4 and 7)

 a. What data in this scenario are pertinent?

 b. What potential collaborative problem(s) could be applicable in this situation?

 c. Which nursing diagnoses would you expect to be applicable regarding the medical procedures in this situation?

 d. Which nursing diagnoses would you expect to be applicable regarding the nursing/medical history in this situation?

 e. Which nursing diagnoses would you expect to be applicable regarding the discharge planning in this situation?

Answer 1

a) Pertinent data are he had undergone surgery for fracture of femur. Complication is bleeding and corrected by fluid replacement.

b) medical problem :hypertension, COPD

Socioeconomic problem : smoking, no support system

Surgery associated problem : bleeding

c) Impaired hemodynamic status hypertension related to ineffective tissue perfusion.

Impaired breathing pattern related to inadequate oxygen supply and demand

Risk for developing non communicable disease related to chronic smoking

Hemorrhage related to surgery

Knowledge deficit related to lack of knowledge regarding smoking, hypertension

Activity intolerance related to immobility.

Ineffective coping related to lack of support system