Hip Fracture

Sakuro Kato is a 80 year old female in the hospital who has a medical history of osteoporosis and hypertension. She is currently recovering from a right hip fracture post-surgery. She is from Japan and lives in the United States to be near children. She does not feel comfortable in the American culture.

Inpatient Hospital Room

1. Perform a focused postoperative assessment, including neurovascular checks (CMS: circulation, motion, sensation), surgical site inspection, vital signs, and pain assessment.
2. Recognize early signs of postoperative complications, such as infection, bleeding, deep vein thrombosis (DVT), pneumonia, urinary retention, and impaired mobility.
3. Implement nursing interventions to prevent complications, including incentive spirometry, turning and repositioning, early ambulation, and anticoagulant administration.
4. Assist the patient with safe mobility and transfers, following hip precautions (e.g., no crossing legs, no bending past 90 degrees).
5. Provide patient education on postoperative care, mobility aids (e.g., walker), pain management, and discharge planning.
6. Demonstrate therapeutic communication to address pain, anxiety, and recovery concerns.
7. Document postoperative care and assessment findings accurately in the medical record using structured formats.

1. Perform a thorough assessment of the surgical site and affected extremity, including circulation, sensation, and movement.
2. Identify abnormal findings (e.g., decreased pulse, increased pain, swelling, redness, fever) and escalate appropriately.
3. Assist the patient in performing incentive spirometry, turning in bed, and initiating out-of-bed mobility with assistive devices.
4. Reinforce hip precautions and assist with safe ambulation using gait belts and walkers.
5. Administer prescribed medications (e.g., anticoagulants, analgesics) safely and monitor for side effects.
6. Communicate empathetically and clearly with the patient and family about the recovery process.
7. Document all care, education, and patient responses using clinical terminology in the EMR or simulation chart.