Question

A 68 y/o female client has come to the healthcare provider’s office with concerns of osteoporosis. She has been becoming more kyphotic and had already lost 1” in height over the last few years. She is 20 years postmenopausal and has never taken hormone replacement therapy. The client is a former secretary and spends much of her time now watching television. She stopped smoking 30 years ago. She has an occasional alcoholic beverage and drinks a cup of coffee each day.

Six months later the client slipped on the ice, fell down, and broke her hip. She was admitted to the hospital and underwent surgery for an open reduction and internal fixation (ORIF) to repair the fracture. She is currently two days post-op and having pain issues. She takes multiple doses or narcotics daily and refuses to ambulate with physical therapy, instead opting to stay in bed.

Based on what you know so far from class, what are some concerns you might have for this client? (List at least five and provide rationales)

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What goals would the client need to meet before being discharged home? (List at least three, prioritize, and provide rationales)

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Answer 1

1

• Deep vein thrombosis can occur due decreased mobility .
• Development of Atelectasis and pneumonia due to impaired mobility.
• Constipation occurs because of decreased mobility coupled with the use of narcotics.
• Consuming alcohol and caffeine further decreases bone density.
• Possibility of skin breakdown.

2

• The goals include improving function by restoring motion and stability .
• Relieving pain
• Relieving Disability