Peri-OP (Total Hip-Replacement) Case Study

The client is a 98-year-old female, admitted to the ER as a result of falling down her stairs. She has been diagnosed with rheumatoid arthritis, a fractured hip and a sprained arm. She has been moved to the ICU and will have a total hip replacement tomorrow. Lorazepam 1mg IV times one dose has been ordered. (20 points each)
• Describe the four elements of the pre-operative check list: identify the nurse’s priority assessments, diagnostics, and anticipated medical orders? Assess for pain,

• What potential complications does the nurse need to assess before and after giving the Lorazepam?
If Lorazepam comes in 2mg/1ml, how many ml does the nurse need to administer?

• Your client is now post-op and has an order for an anticoagulant. The order is for Enoxaparin 40mg BID. Provide the rational for using this medication versus Heparin?

• Describe postoperative priority assessments for your client given her age, surgery and history.

• Discuss any nonpharmacological treatments that can be used instead of narcotic pain medications and identify if there are any contraindications given the client’s comorbidities.

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