Question

Abigail Cantonelli, age 80, injured her left knee and wrist when she fell on an icy sidewalk. She has been on your orthopedic and neurologic unit for several days. She has a history of cardiomyopathy, for which she receives furosemide. Her vital signs are stable and she rates her pain as aching, intermittent, and a 2 on a scale of 1 to 10 (10 = worst pain). Because Mrs. Cantonelli has an increased risk of falling, her health care provider has ordered physical therapy and cane-walking instructions before discharge. Although the physical therapy staff has already initiated the cane-walking instructions, you will need to ambulate Mrs. Cantonelli with her cane during your shift. While you are ambulating down the hall, she says, “Oh, dear! I feel dizzy.” She begins to lose her balance and starts to fall toward you.

Prescribed Interventions
Physical Therapy for cane walking instruction
Ambulate every shift with cane assistance
Furosemide 20mg PO every morning
Potassium Chloride 10meq PO everyday
Naprosyn 275mg PO q6-8h prn pain

Questions:

1. Identify Mrs. Cantonelli’s risk factors for falling
2. Describe the actions you would implement when Mrs. Cantonelli begins to fall
3. Considering these risk factors, what special assessments and precautions should you implement before assisting her to ambulate or while assisting her with ambulation?

Answer 1

The risk factors of Mrs.Cantonelli are

• Age (80years)
• Injury (left kneeand wtist)

Others

• Medical condition (cardiomyopathy )
• Mecication

The following action a has to be implemented immediately

• Make her sit immediately by getting a chair with the help of co worker
• Support her by holding her pant as a good grip
• Maintain proper body posture to balance self and patient
• Use the help of the can to balance the patient

The special assessment are needed before mobilization

• Assess for vital signs to give a basic idea on the health status of the patient
• Assess for pain to ensure that patient can walk
• Assess whether pain medication was taken that day
• Know the patient's willingness to ambulate
• Assess for any bleeding,redness,swelling at the site of injury

The precaution necessary for this patient are

• Keep a chair behind the patient while walking so that if she is feeling tired or dizzy can be made to sit immediately
• Make sure there are enough assistance while ambulating the patient