Question

Jolly Rogers, a 72-year-old female client who lives alone in a townhouse, arrives to the medical-surgical unit after falling down seven icy steps in front of her home. The vital signs are T, 97° F; BP, 130/80 mm Hg; HR, 88 beats/minute; RR, 22 breaths/minute. She is 5 foot 4 inches tall and weighs 120 lb. She has a history of osteoporosis and diabetes controlled with diet. The client stated she has pain in her right arm rated as 6/10, and pain in her right hip rated as 8/10. There is visible bruising and swelling at the right elbow. The right leg appears shorter than the left leg, with external rotation of the leg and inability to move it and bruising and edema at the site. The LPN needs to perform a complete musculoskeletal system assessment.

1. Using the nursing process develop a plan of care for Mrs. Rogers

2. What additional history questions are needed?

Answer 1

Nursing Process:

1. Knowledge about Osteoporosis and treatment plan to be discussed with patient.

2. Diet rich in Calcium & Vitamin D food to be identified abd discuss about calcium supplements.

3. Weight bearing exercise plan.

4. to achieve pain relief.

5. To prevent injury by walking etc.

6. water consumption increase

7. weight reduction plan

8. estrogen replacement.

For leg length discrepancy, measurement need to be tken.

X ray need to be analysed of the hip bone & lower limbs. CT scan can be done to examine the bone density.

Anti inflammatory drugs need to be administered to reduce bruise and edema.

Inspsctin & palpation needs to be done for examination.

Additional history questions :

1. Any surgeries on the right limbs or hip?

2. Any bone fractures in the right side of the hip or limbs.

3. whether limb length discrepancies are present since childhood?