John 50 yr/old male admitted 2 days ago due to a right hip fracture from a MVA

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John 50 yr/old male admitted 2 days ago due to a right hip fracture from a MVA by Mind Map: John 50 yr/old male admitted 2 days ago due to a right hip fracture from a MVA

1. Pathophysiology of Primary Dx: Disruption of the bony structure of Pelvis

2. Nursing assessment of Primary Dx: assess for redness, swelling, warmth, and tenderness; control patient pain; vitals (fever, blood pressure), check for sensation of feeling; check for CMS

3. Secondary Dx: Type II Diabetes Mellitus

3.1. Pathophysiology: Genetic and environmental--> Insulin resistance--> decreased glucose uptake--> hyperglycemia

3.2. Nursing assessment: Monitor blood sugar, infection, check lower extremities, perform neurological function test

3.3. Risk factors: *risk for infection, Native American decent, *risk for impaired skin integrity, *risk for unstable blood glucose level

3.4. Clinical Manifestations: *Polydipsia, *polyuria, *obesity, recurrent blurred vision, fatigue, paresthesia, *skin infection

3.5. Diagnostics: OGTT (pregnant women), A1C, fasting glucose, random glucose

4. Risk factors: elderly, *obese, substance abuse, *osteoporosis, *pneumonia

5. Clinical Manifestations: *infection; *pain/tenderness in hip, groin, or lower back; *bruising/swelling; *numbness/tingling; *hypovolemic shock

6. Nursing Dx #1: Impaired Comfort

6.1. Outcome: patient will maintain 4/10 on pain scale at end of hospital stay

6.1.1. Nursing Interventions: pillow wedge, pain scale, heat/ice therapy, pain medication

7. Nursing Dx #2: Impaired Physical Mobility

7.1. Outcome: Patient will reposition every 2 hours

7.1.1. Nursing Interventions: passive ROM, OT/PT, turning/repositioning, assistive devices

8. Nursing Dx #3: Anxiety

8.1. Outcome: Patient will have therapy dog visit one time daily

8.1.1. Nursing interventions: aroma therapy, education, relaxation/meditation, religious views (chaplaincy)

9. Diagnostics: X-ray, ultrasound, MRI, CT scan

10. Psychosocial/ Family Dynamics: John is the caregiver for his wife who was diagnosed with MS in the past. This is causing him stress because he is not sure how of how he will take care of her while he is in the hospital. Stress is the body's reaction to change that requires adjustment.