NUR 3516 Week 2 Handout Assignment

NUR 3516 Week 2 Handout Assignment

NUR 3516 Week 2 Handout Assignment

Clinical Reasoning Writing Assignment

NUR 3516

My current client is an 85-year-old female who has recently been diagnosed with a left hip fracture. This client also has a history of osteoporosis. Osteoporosis is a condition in which the bones become weak and brittle, mineral density, and bone mass decreases. In osteoporosis, the formation of new bone cannot keep up with old bone removal. In this process, the bones become porous making fractures common (Taylor, C., Lynn, P., & Bartlett, J. L. 2019. p.565 NUR 3516 Week 2 Handout Assignment). Knowledge of the bone remolding process is key to fully understanding this disease process.

Bone remodeling is completed in three phases. Resorption is when the body removes a small amount of bone mineral. Reversal where mononuclear cells begin to appear on bone. Lastly formation of new bone minerals (Raisz, L. G. 2005). This allows the body to maintain a balance in bone formation and destruction, this balance is not maintained in patients with osteoporosis resulting in loss of calcium, phosphorus, and bone matrix. Bone remodeling is vital in meeting the demands of the changing body and repairing damages made to the bones. The cause of osteoporosis in my client’s case can be due to age-related factors.

As we age hormonal changes take place. Since my client is female physical symptoms of hormonal losses are apparent. A significant loss of estrogen is common, leading to physical effects like osteoporosis. With the known history of osteoporosis in my client’s case, it can be assumed that the weakening of bones is the cause of the fracture.

My patient’s current medications include medications for pain management and medications due to my client being immobile. Enoxaparin sodium is a blood thinner, that is used for immobile patients to prevent clots from forming where they are not supposed to like deep vein thrombosis or pulmonary embolism. It is important to assess this client for any  abnormal bleeding epically at the fracture site since this medication has a narrow therapeutic window. As the nurse assessment clotting factor time to prevent my patient from bleeding out. It is key to inform my client to report any abnormal bleeding and when released from the hospital to avoid using razors and be careful not to tear the skin since their blood is not thinner than normal.

Docusate sodium is another prescribed medication for my client, this medication is used as a stool softener. Since my client is expected for surgery, on opioid medications, and is immobile constipation is a problem that can arise. It is important to remember to not administer Docusate sodium within one hour of other medications, also checking for any rectal bleeding, in this case, is key since the client is on a blood thinner. It is necessary to teach the client that this medication can increase their bowel movement cause an upset stomach and in. Morphine is prescribed to manage my client’s pain levels and provide as much comfort as possible.

Since my client has been prescribed Morphine every four hours for the pain it is important to assess my client’s pain levels every four hours to see if the medication is needed to decrease the possibility of becoming addicted to the medication since it is an opioid. Before administering this medication my client’s vital signs should be assessed along with alertness and orientation. Teaching my client to report any difficulty breathing as this can be a sign of an adverse reaction to the medication.

Routine assessment should be completed on my client. Vital signs should be obtained every four hours to monitor my patient’s overall well-being. Assessment of my client’s skin should be performed such as being turned every four hours since they are immobile to prevent skin break down. The skin should also be assessed at the fracture site to see any bruising and determine the condition of the skin. The temperature of the skin should also be monitored to avoid infection. NUR 3516 Week 2 Handout Assignment

Assessment of the IV and IV site is needed to make sure that the IV is infusing appropriately. Lastly, make sure the client is alert and oriented and responds appropriately to the prescribed medications. When caring for my client the number one priority is care and comfort. I will complete this by routinely checking my patient’s pain level to know when pain medications are needed, or if current medications are not working for my client. Repositioning my client will also be beneficial to help relieve the pressure that can build up from laying in the same spot.

Finally, I will assess my clients understanding to use the call light whenever they need something
to ensure that my client is safe.

References

Lilley, L. L., Collins, S. R., & Snyder, J. S. (2020). Pharmacology and the nursing process.
Elsevier.

Raisz, L. G. (2005, December). Pathogenesis of osteoporosis: Concepts, conflicts, and prospects.
The Journal of clinical investigation. Retrieved March 22, 2022, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1297264/

Taylor, C., Lynn, P., & Bartlett, J. L. (2019). Fundamentals of Nursing: The art and science of
person-centered care. Wolters Kluwer.