An older adult client experiences a hip fracture. Prior to the ...

[RODY.ELKHALIL]

An older adult client experiences a hip fracture. Prior to the injury, the client participated in golf and home maintenance activities. Based on this data, which surgical procedure does the nurse anticipate?
 
  A) Total hip replacement
  B) Open reduction and external fixation
  C) Austin-Moore prosthesis
  D) Open reduction and internal fixation

Question 2

The nurse is evaluating care provided to a client recovering from hip replacement surgery. Which piece of documentation in the medical record indicates that the client has achieved the expected outcome for pain management?
 
  A) The client states pain is a 6 on a numeric pain scale of 1 to 10 prior to evening care.
  B) The client is crying and requesting pain medication prior to morning care.
  C) The client is using PCA pump around the clock and rates pain as a 2 on a numeric pain scale of 1 to 10.
  D) The client refuses pain medication prior to physical therapy. Pain is rated as a 7 on a numeric pain scale of 1 to 10.

[micaelaswann]

Answer to Question 1

Answer: D

The open reduction and internal fixation is the surgical preference to repair a fractured hip for older adult clients who are active and will be able to use crutches with partial weight bearing. A total hip replacement is done only when severe arthritis is present. Austin-Moore prosthesis is preferred for the less active older adult client. Open reduction and external fixation is not a surgical option for a fractured hip.

Answer to Question 2

Answer: C

Expected outcomes for pain management following a hip replace surgery are the use of a PCA pain, or other pain interventions, that allows the pain to have a pain level of 3 or below when assessed using a numeric pain scale. The client who is using the PCA pain and states that the pain is a 2 on a numeric pain scale of 1 to 10 has achieved an expected outcome for pain management. The client who states that pain is a 6, the client who is crying and requesting pain medication, and the client who refuses pain medication even though the rating is a 7 have not meet the expected outcome for pain management after a hip replacement surgery.