HIP REPLACEMENT

Hip Replacement



Introduction1

Patient presentation2

Diagnosis2

Overview of Nursing Models and Nursing Process3

Assessment4

Planning5

Intervention6

Evaluation9

Recommendation for practice11

Conclusion19

References20

Hip Replacement

Introduction

The reason why fractured neck of femur was chosen for this study was that because I had my recent placement in an orthopaedic ward. Fractured neck of femur is a common serious injury amongst elderly people which causes morbidity and mortality. A neck of femur fracture is a (crack or break) in the top end or 'neck' of the femur, nearest the hip joint. The main general types of hip fractures are Intra capsular and extra capsular, the intra capsular is when the fracture is within the joint capsule and extra capsule is outside the joint capsule. Neck of the femur fracture may also damage the vascular system that supplies blood to the head and the neck of the femur, causing the bone to die. The fracture of an individual determines the treatment the orthopaedic surgeons suggest. Around 75,000 hip fractures are being treated each year in UK, and with its aging population the number is predicted to double by 2050.

Patients admitted due to neck of femur fractures are likely to get worse during their hospital stays, due to poor nutrition, pressure ulcers as hip fractures could trigger other problems and affect the immune system. The essay focuses on a 48hr care of a patient who has been admitted with a left fractured neck of femur, as a nursing student this topic was to help and extend my knowledge and understanding the management of fractures. Nurses ought to have the skills on knowing how to assist their patients with hip fractures for quick recoveries. According to the Nursing and Midwifery Council, all names and locations used in the essay have been changed in order to maintain confidentiality of the patient.

Patient presentation

Phillip is a 90 year old, independent male who lives alone. He is retired; he had a fall when moving a bin in back garden and fell onto left side landing on left hip and banging rear of head on paving. A neighbour had him shouting and came to see what was happening, and called for an ambulance. Patient was complaining of pain in left hip. He was admitted to the Accident and Emergency Department (A&E). On examinations Phillip had a 5cm apparently superficial lac to rear of head, bleeding had ceased haematoma with bruising, no headache, no visual disturbances, and no nausea. His left leg appeared shorter and internally rotated and unable to raise left leg, pain free at rest and increased pain on movement, increased pain on palpation, no groin pain. He was cold, good recent health, no neck pain, no central spinal pain, no chest pain, raised BM. His past medical history presented osteoporosis and Type 1 diabetes. Phillip has never drunk or smoked in his life. He has no known drug or food allergies known. The x-rays of his hip and pelvis, shown in Figure 1A, B, show a displaced, comminuted subcapital fracture of the femoral ...